Hardus P, Verduin W M, Berendschot T T, Kamermans M, Postma G, Stilma J S, van Veelen C W
Department of Ophthalmology, Academic Hospital Groningen, The Netherlands.
Acta Ophthalmol Scand. 2001 Apr;79(2):169-74. doi: 10.1034/j.1600-0420.2001.079002169.x.
To determine the value of electrophysiological findings in patients with temporal lobe epilepsy and to relate these findings to the amount of concentric contraction of the visual field and the use of vigabatrin.
Electro-retinograms and electro-oculograms were done on 30 patients, operated for temporal lobe epilepsy. The patients were divided into three groups: (A) concentric contraction of the visual field associated with a history of vigabatrin medication (15 patients), (B) normal visual field with vigabatrin use (11 patients) and (C) normal visual field without vigabatrin medication (4 patients).
Electrophysiological abnormalities were found in 50% of the patients in group A. The Arden ratio of the EOG was lowered in 57%. Abnormalities in the ERG were found: b-wave implicit time photopic F was prolonged (50%), b-wave amplitudes scotopic B (53%), C (73%) and G (50%) and photopic H (50%) were diminished. The amount of visual field loss and the total dose of vigabatrin used, showed only slight correlation with the ERG and EOG. The use of vigabatrin during the ERG and EOG recording in group A, gave a higher b-wave amplitude scotopic G in 64% of cases. The a-wave implicit times scotopic G (73%) and photopic G (59%) and H (73%) were shortened in group B.
EOG was abnormal in 57% in group A. ERG abnormalities could only be found in 50% of group A, mainly in the inner retina. Since also the total dose of vigabatrin and the amount of visual field loss did not really show a correlation with the electrophysiological findings and results of literature are not unanimous, electrophysiology does not appear at present to be a good method to detect patients with, or at risk of, vigabatrin associated visual field loss. Regularly performed visual field examination remains the cornerstone in screening.
确定颞叶癫痫患者电生理检查结果的价值，并将这些结果与视野同心性收缩程度及氨己烯酸的使用情况相关联。
对30例接受颞叶癫痫手术的患者进行视网膜电图和眼电图检查。患者分为三组：（A）有氨己烯酸用药史且伴有视野同心性收缩的患者（15例），（B）使用氨己烯酸但视野正常的患者（11例），以及（C）未使用氨己烯酸且视野正常的患者（4例）。
A组50%的患者存在电生理异常。眼电图的Arden比值在57%的患者中降低。视网膜电图发现异常：明视F波b波潜伏期延长（50%），暗视B波（53%）、C波（73%）、G波（50%）以及明视H波（50%）的b波振幅降低。视野缺损程度和氨己烯酸的总用量与视网膜电图和眼电图仅显示出轻微相关性。在A组进行视网膜电图和眼电图记录期间使用氨己烯酸，64%的病例暗视G波b波振幅升高。B组暗视G波（73%）、明视G波（59%）和H波（73%）的a波潜伏期缩短。
A组57%的患者眼电图异常。仅50%的A组患者存在视网膜电图异常，主要在内层视网膜。由于氨己烯酸的总用量和视野缺损程度与电生理检查结果并未真正显示出相关性，且文献结果也不一致，目前电生理检查似乎并非检测氨己烯酸相关视野缺损患者或有此风险患者的良好方法。定期进行视野检查仍是筛查的基石。
