Yenjun Suthida, Harvey A Simon, Marini Carla, Newton Mark R, King Mark A, Berkovic Samuel F
Epilepsy Research Institute and Department of Medicine (Neurology), University of Melbourne, Austin and Repatriation Medical Centre, Melbourne, Australia.
Epilepsia. 2003 Feb;44(2):252-6. doi: 10.1046/j.1528-1157.2003.26402.x.
It remains controversial whether adult-onset idiopathic generalized epilepsy (IGE) is a distinct syndrome or a continuum among IGE syndromes. EEG is the only known biologic marker of IGE and helps differentiate many of its classic subsyndromes. In this study, we looked for the differences in the EEG findings of IGE of classic adolescent onset versus adult onset that may suggest syndromic heterogeneity.
Seventy-six patients (47 adolescent-onset IGE, 29 adult-onset IGE) with a clinical and EEG diagnosis of IGE were included. We defined IGE with age at onset of 11-20 years as adolescent-onset IGE and age at onset of 20 years or after as adult-onset IGE. Patients with first-decade onset of seizures, delayed EEGs, and no EEG available for review were excluded. The first EEG was performed within 24 h of the seizure, and if negative, a sleep-deprived EEG was done. All EEGs were reviewed in detail with respect to the background activity and the generalized spike-wave (GSW) characteristic.
EEGs (87; 56 adolescent-onset IGE, 31 adult-onset IGE) were systematically reviewed. Background was normal in all patients. The morphology, amplitude, duration, frequency, occurrence, or activation of the GSW pattern did not differ between these two groups.
No differences of EEG features were found between the classic adolescent-onset and the adult-onset IGE. This supports the hypothesis that they share common biologic determinants and exist along a life-long age spectrum of classic IGE.
成人起病的特发性全面性癫痫（IGE）究竟是一种独特的综合征还是IGE综合征之间的连续体，这一点仍存在争议。脑电图（EEG）是已知的唯一IGE生物学标志物，有助于区分其许多经典亚综合征。在本研究中，我们探寻经典青少年起病与成人起病的IGE在EEG表现上的差异，这些差异可能提示综合征的异质性。
纳入76例临床及EEG诊断为IGE的患者（47例青少年起病的IGE，29例成人起病的IGE）。我们将起病年龄在11 - 20岁的IGE定义为青少年起病的IGE，起病年龄在20岁及以后的定义为成人起病的IGE。排除癫痫发作于首个十年、EEG延迟以及无可用EEG进行评估的患者。首次EEG在癫痫发作后24小时内进行，若结果为阴性，则进行剥夺睡眠EEG检查。所有EEG均就背景活动和全面性棘慢波（GSW）特征进行详细评估。
对87份EEG（56份青少年起病的IGE，31份成人起病的IGE）进行了系统评估。所有患者的背景均正常。这两组之间GSW模式的形态、振幅、持续时间、频率、出现情况或激活情况并无差异。
经典青少年起病和成人起病的IGE之间未发现EEG特征上的差异。这支持了以下假设，即它们具有共同的生物学决定因素，且存在于经典IGE的终生年龄谱中。
