Tataroglu Cengiz, Ozkiziltan Safa, Baklan Baris
Department of Neurology, Medical Faculty, Mersin University, Zeytinlibahce Cadd., Mersin 33079, Turkey.
Seizure. 2004 Oct;13(7):481-5. doi: 10.1016/j.seizure.2003.11.003.
We studied motor cortical thresholds (TIs) and cortical silent periods (SPs) evoked by transcranial magnetic stimulation (TMS) in 110 epileptic patients. Sixty-two had primary generalised, 48 had partial type seizures. Fifteen out 110 patients were analysed both before and after anticonvulsant medication. Our aims were to evaluate the TI levels and the duration of SPs in patients with epilepsy and to determine the reliability of TMS in patients with epilepsy. There was no negative effect of TMS on the clinical status and EEG findings in patients with epilepsy. TIs obtained from patients with partial epilepsy were higher than those obtained from both controls and primary epileptics. The duration of SP in patients with primary epileptics was more prolonged than those obtained from controls. There was no correlation between EEG lateralisation and both SP duration and TI values. In de novo patient group, SP duration was significantly prolonged after anticonvulsant medication. We concluded that TMS is a reliable electrophysiological investigation in patients with epilepsy. The analysis of SP duration may be an appropriate investigation in monitoring the effect of anticonvulsant medication on the cortical inhibitory activity.
我们对110例癫痫患者进行了经颅磁刺激（TMS）诱发的运动皮质阈值（TIs）和皮质静息期（SPs）的研究。其中62例为原发性全身性癫痫，48例为部分性癫痫发作。110例患者中有15例在抗惊厥药物治疗前后均进行了分析。我们的目的是评估癫痫患者的TI水平和SPs持续时间，并确定TMS在癫痫患者中的可靠性。TMS对癫痫患者的临床状态和脑电图结果没有负面影响。部分性癫痫患者的TI高于对照组和原发性癫痫患者。原发性癫痫患者的SP持续时间比对照组更长。脑电图偏侧化与SP持续时间和TI值之间均无相关性。在初发患者组中，抗惊厥药物治疗后SP持续时间显著延长。我们得出结论，TMS是癫痫患者可靠的电生理检查方法。分析SP持续时间可能是监测抗惊厥药物对皮质抑制活动影响的合适检查方法。
