Kutluay E, Passaro E A, Gomez-Hassan D, Beydoun A
Department of Neurology, University of Michigan, Ann Arbor, Michigan 48109, USA.
Epilepsia. 2001 Dec;42(12):1563-8. doi: 10.1046/j.1528-1157.2001.16401.x.
Midline epileptiform discharges are rare compared with discharges at other scalp locations. Neuroimaging results and semiologic seizure characteristics of patients with midline spikes are not adequately described. The aim of this study was to describe the neuroimaging findings and detailed seizure semiologies in patients with midline spikes.
We reviewed the EEG database of the University of Michigan Medical Center and identified 35 patients with midline spikes. Information about seizure types and neuroimaging results was obtained from a review of medical records. The seizures were classified according to the International League Against Epilepsy (ILAE) criteria and semiologic classification.
Twenty-nine (83%) patients had a history of seizures. Complex partial seizures and simple partial seizures were the most common seizure types, experienced by 66% of patients. The age at seizure onset was within the first 10 years in 90% of patients. According to the semiologic seizure classification, automotor seizures and tonic seizures were the most common seizure types. Neuroimaging studies were abnormal in 45% of patients. When focal abnormalities were detected, they were lateralized to one of the frontal lobes in all cases.
Our results indicate that in the majority of patients, midline spikes represent focal epileptiform activity rather than fragments of generalized discharges, and are most commonly associated with seizures of partial onset. Automotor seizures and tonic seizures are the most common semiologies. Focal radiologic abnormalities tend to be lateralized to one of the frontal lobes.
与其他头皮部位的放电相比，中线癫痫样放电较为罕见。中线棘波患者的神经影像学结果和癫痫发作的症状学特征尚未得到充分描述。本研究的目的是描述中线棘波患者的神经影像学发现和详细的癫痫发作症状学。
我们回顾了密歇根大学医学中心的脑电图数据库，确定了35例中线棘波患者。通过查阅病历获取癫痫发作类型和神经影像学结果的信息。癫痫发作根据国际抗癫痫联盟（ILAE）标准和症状学分类进行分类。
29例（83%）患者有癫痫发作史。复杂部分性发作和简单部分性发作是最常见的发作类型，66%的患者有过此类发作。90%的患者癫痫发作起始年龄在10岁以内。根据癫痫发作症状学分类，自动症发作和强直发作是最常见的发作类型。45%的患者神经影像学检查异常。当检测到局灶性异常时，所有病例均定位于额叶中的一个。
我们的结果表明，在大多数患者中，中线棘波代表局灶性癫痫样活动而非全身性放电的片段，并且最常与部分性发作的癫痫相关。自动症发作和强直发作是最常见的症状学表现。局灶性放射学异常往往定位于额叶中的一个。
