Ergene E, Shih J J, Blum D E, So N K
Department of Neurology, University of New Mexico School of Medicine, Albuquerque, USA.
Epilepsia. 2000 Feb;41(2):213-8. doi: 10.1111/j.1528-1157.2000.tb00142.x.
Bitemporal interictal epileptiform discharges (IEDs) occur in < or =42% of scalp EEGs in patients with temporal lobe epilepsy (TLE) studied with routine EEGs or partial analysis of long-term recordings.
Twenty-eight patients with TLE demonstrating exclusively unilateral temporal IEDs on routine EEGs underwent 24-h continuous recording. The entire record was visually inspected for epileptiform discharges. We used continuous EEG to assess the significance of long-term recording in detecting bilateral IEDs.
Twenty-two patients had left temporal IEDs; 21 had right temporal IEDs. Seventeen (61%) patients had IEDs originating from both the right and left temporal lobes. The probability of detecting bilateral independent IEDs was correlated with the duration of continuous EEG recording. There was no correlation between the number of IEDs originating from one side and the probability of detecting independent IEDs on the other side. The frequencies of IEDs were not correlated with the length of time since onset of epilepsy.
The findings suggest that when long-term recordings are performed, the incidence of bilateral discharges in TLE is higher than previously reported in the literature and supports the view that TLE is commonly a bilateral disease.
在采用常规脑电图(EEG)或长期记录部分分析对颞叶癫痫(TLE)患者进行研究时,双侧发作间期癫痫样放电(IEDs)出现在≤42%的头皮EEG中。
28例在常规EEG上仅显示单侧颞叶IEDs的TLE患者进行了24小时连续记录。对整个记录进行肉眼检查以寻找癫痫样放电。我们使用连续EEG来评估长期记录在检测双侧IEDs方面的意义。
22例患者有左侧颞叶IEDs;21例有右侧颞叶IEDs。17例(61%)患者的IEDs起源于右侧和左侧颞叶。检测双侧独立IEDs的概率与连续EEG记录的持续时间相关。一侧起源的IEDs数量与另一侧检测到独立IEDs的概率之间无相关性。IEDs的频率与癫痫发作起始后的时间长度无关。
研究结果表明,当进行长期记录时,TLE中双侧放电的发生率高于文献中先前报道的,支持TLE通常是双侧性疾病的观点。