Sakai Yuzo, Nagano Hiromi, Sakata Ayumi, Kinoshita Sachiko, Hamasaki Naotaka, Shima Fumio, Morioka Takato
Department of Clinical Chemistry and Laboratory Medicine, Kyushu University Faculty of Medicine.
Seizure. 2002 Apr;11(3):163-8. doi: 10.1053/seiz.2001.0603.
Our aim was to evaluate the ability to localize the epileptogenic zone in temporal lobe epilepsy (TLE) by ictal scalp electroencephalogram (EEG). Using simultaneous video recording, we analysed scalp EEG activity during ictal periods in 38 patients (30 patients with medial TLE (MTLE) and eight with lateral TLE (LTLE)). In 14 patients, intracranial ictal EEGs were recorded with depth electrodes, and simultaneous recordings of scalp and intracranial EEG were performed in 11 patients. Scalp EEG showed that, in all 30 patients with MTLE (71 of 72 seizures), an attenuation of background activity was observed before the appearance of ictal activity. Ictal discharges first appeared in the scalp EEG when the ictal discharges reached the lateral part of the temporal lobe on the intracranial EEG. While, in all eight patients with LTLE (25 of 25 seizures), the attenuation of background activity did not occur before the appearance of ictal activity. When the ictal discharges started in the lateral temporal lobe on intracranial EEG, ictal discharges appeared on the scalp. MTLE and LTLE could be diagnosed by the presence or absence of attenuation of background activity with clinical ictal signs before the appearance of ictal discharges.
我们的目的是通过发作期头皮脑电图（EEG）评估颞叶癫痫（TLE）中癫痫发作起始区的定位能力。利用同步视频记录，我们分析了38例患者（30例内侧颞叶癫痫（MTLE）患者和8例外侧颞叶癫痫（LTLE）患者）发作期的头皮EEG活动。14例患者使用深部电极记录了颅内发作期EEG，11例患者同时记录了头皮和颅内EEG。头皮EEG显示，在所有30例MTLE患者中（72次发作中的71次），在发作期活动出现之前观察到背景活动减弱。当颅内EEG上的发作期放电到达颞叶外侧部分时，发作期放电首次出现在头皮EEG上。而在所有8例LTLE患者中（25次发作中的25次），在发作期活动出现之前未出现背景活动减弱。当颅内EEG上的发作期放电在颞叶外侧开始时，发作期放电出现在头皮上。MTLE和LTLE可通过在发作期放电出现之前是否存在伴有临床发作体征的背景活动减弱来诊断。
