Choi Eun Jung, Kang Joong Koo, Lee Sang Ahm
Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Seizure. 2006 Dec;15(8):576-81. doi: 10.1016/j.seizure.2006.08.001. Epub 2006 Oct 4.
We investigated whether there is a cluster effect depending on localization of seizure foci in patients with bilateral seizure foci. We evaluated 171 seizure pairs from 193 seizures recorded in 28 patients. Seizure lateralization was determined by the lateralization of ictal discharges; if the ictal EEG pattern was not lateralized, lateralization was determined by clinical seizure semiology. The logarithm of the interseizure interval (ISI) was significantly related to seizure concordance only in patients with extratemporal seizure foci, but not in those with bitemporal foci. In the former group, the mean ISI for concordant seizure pairs was significantly shorter than that for discordant seizures pairs (292 min versus 631 min, p=0.023). Seizure types composing seizure pairs had a significant influence on ISI regardless of the localization of seizure foci. ISIs were shortest in seizure pairs with only partial seizures. However, types of seizure pairs were significantly related to concordance rates of seizure lateralization only in patients with extratemporal foci (p=0.005). In conclusion, our results suggest that the cluster effect on seizure localization exists in patients with extratemporal seizure foci, but not in those with bitemporal foci.
我们研究了双侧癫痫病灶患者中是否存在取决于癫痫病灶定位的聚集效应。我们评估了28例患者记录的193次发作中的171对发作。癫痫发作的侧别由发作期放电的侧别确定；如果发作期脑电图模式未显示侧别，则根据临床发作症状学确定侧别。仅在颞叶外癫痫病灶患者中，发作间期（ISI）的对数与发作一致性显著相关，而在双颞叶病灶患者中则不然。在前一组中，一致性发作对的平均ISI显著短于不一致性发作对（292分钟对631分钟，p = 0.023）。无论癫痫病灶的定位如何，构成发作对的癫痫发作类型对ISI均有显著影响。仅部分发作的发作对的ISI最短。然而，仅在颞叶外病灶患者中，发作对的类型与癫痫发作侧别的一致性率显著相关（p = 0.005）。总之，我们的结果表明，颞叶外癫痫病灶患者存在对癫痫发作定位的聚集效应，而双颞叶病灶患者则不存在。
