Tao James X, Baldwin Maria, Hawes-Ebersole Susan, Ebersole John S
Department of Neurology, Adult Epilepsy Center, The University of Chicago, Chicago, Illinois 60637, USA.
J Clin Neurophysiol. 2007 Apr;24(2):96-100. doi: 10.1097/WNP.0b013e31803ecdaf.
Scalp EEG is an essential component of epilepsy presurgical evaluation during the lateralization and localization of epileptogenic focus. Scalp EEG epileptiform discharges may either guide direct surgical intervention or provide necessary information to further localize the epileptic focus with intracranial EEG recording. Despite the importance and widespread use of scalp EEG epileptiform discharges, the cortical EEG substrates underlying these spikes and seizure discharges are mostly speculative. Misconceptions are therefore prevalent regarding the necessary cortical area, synchrony, and amplitude required to generate those that are recordable at the scalp. Using contemporary EEG recording techniques such as simultaneous scalp and intracranial EEG recording, the authors' recent studies have shown that the cortical area of epileptiform discharges required for the scalp recording is considerably larger than commonly thought. A cortical area of 10 to 20 cm is often required to generate a scalp recognizable interictal spike or ictal rhythm. Sufficient cortical source area and synchrony are mandatory factors for the corresponding scalp EEG epileptiform recording. The amplitude is primarily dependent on source area and synchrony; therefore it is a less important factor. The authors review the previous literatures in conjunction with their recent investigations on this topic.
头皮脑电图是癫痫术前评估中确定致痫灶侧别和位置的重要组成部分。头皮脑电图痫样放电可指导直接手术干预，或为通过颅内脑电图记录进一步定位癫痫病灶提供必要信息。尽管头皮脑电图痫样放电很重要且应用广泛，但这些棘波和发作性放电背后的皮质脑电图基础大多只是推测。因此，对于在头皮上可记录到的痫样放电所必需的皮质区域、同步性和振幅，存在普遍的误解。利用当代脑电图记录技术，如同步头皮和颅内脑电图记录，作者最近的研究表明，头皮记录所需的痫样放电皮质区域比通常认为的要大得多。通常需要10至20平方厘米的皮质区域才能产生头皮可识别的发作间期棘波或发作期节律。足够的皮质源区和同步性是相应头皮脑电图痫样记录的必要因素。振幅主要取决于源区和同步性；因此它是一个不太重要的因素。作者结合他们最近在该主题上的研究回顾了以前的文献。
