Wolff Markus, Weiskopf Nikolaus, Serra Emilio, Preissl Hubert, Birbaumer Niels, Kraegeloh-Mann Ingeborg
Department of Neuropediatrics, University Children's Hospital, Tuebingen, Germany.
Epilepsia. 2005 Oct;46(10):1661-7. doi: 10.1111/j.1528-1167.2005.00255.x.
Benign partial epilepsy (BPE) in childhood is characterized by the occurrence of interictal stereotyped focal spikes with variable localization in the EEG. Children with BPE often exhibit neuropsychological deficits. It is unclear whether a correlation exists between these deficits and the localization of spikes, several EEG studies giving inconsistent results. Magnetoencephalography (MEG) improves the accuracy of spike localization. Therefore by using combined MEG/EEG, we investigated the topographic relation between focal spikes and neuropsychological findings in children with BPE.
Twenty-seven children diagnosed consecutively with BPE were enrolled in the study. All were examined by combined MEG/EEG and magnetic resonance imaging (MRI). Location of spikes was determined by dipole source estimation. A standardized neuropsychological assessment was conducted, including Kaufman ABC battery, language tests, and motor performance series. All children with sufficient MEG data were included in the correlation analysis (N = 20).
Focal spikes were located in the perisylvian region in 13 children, in the occipital region in seven, and in the frontal region in one. Five children had bilateral or multiple foci. Children with left perisylvian spikes did not differ from the others in global IQ, but performed significantly lower in language tests (p = 0.01). Children with occipital spikes performed significantly lower in simultaneous information processing (p = 0.01), especially in visual transformation tasks.
Combined MEG/EEG investigation is a useful tool to examine interictal focal spikes. Our results show a correlation between the location of spikes and selective cognitive deficits in children with BPE. These findings indicate that focal interictal spikes may interfere with complex cognitive functions.
儿童良性部分性癫痫（BPE）的特征是脑电图（EEG）出现发作间期刻板性局灶性尖波，其定位多变。BPE患儿常表现出神经心理缺陷。目前尚不清楚这些缺陷与尖波定位之间是否存在关联，多项EEG研究结果并不一致。脑磁图（MEG）可提高尖波定位的准确性。因此，我们通过联合使用MEG/EEG，研究了BPE患儿局灶性尖波与神经心理结果之间的地形关系。
连续纳入27例诊断为BPE的儿童。所有患儿均接受MEG/EEG联合检查及磁共振成像（MRI）检查。通过偶极子源估计确定尖波的位置。进行标准化神经心理评估，包括考夫曼儿童能力成套测验、语言测试和运动表现系列测试。所有有足够MEG数据的儿童均纳入相关性分析（N = 20）。
13例患儿的局灶性尖波位于颞叶周围区域，7例位于枕叶区域，1例位于额叶区域。5例患儿有双侧或多个病灶。左侧颞叶周围有尖波的患儿在总体智商上与其他患儿无差异，但在语言测试中表现显著较低（p = 0.01）。枕叶有尖波的患儿在同时性信息处理方面表现显著较低（p = 0.01），尤其是在视觉转换任务中。
MEG/EEG联合检查是检查发作间期局灶性尖波的有用工具。我们的结果显示BPE患儿尖波位置与选择性认知缺陷之间存在相关性。这些发现表明发作间期局灶性尖波可能会干扰复杂的认知功能。
