Gotman J
Montreal Neurological Institute, McGill University, Québec, Canada.
Can J Neurol Sci. 1991 Nov;18(4 Suppl):573-6. doi: 10.1017/s031716710003273x.
Epileptic seizures of focal origin often occur unpredictably as do interictal spikes. It is often assumed that spikes increase prior to seizures of focal origin and that antiepileptic medication affects spikes and seizures in a parallel fashion. We review evidence that this assumption is invalid and that there is a clear dissociation between spikes and seizures: increases in spiking before seizures have not been clearly documented; decreases in antiepileptic medication do not result directly in increased spiking; seizures are often followed by long-lasting increases in spiking; finally, seizures are no more likely when spikes are frequent than when spikes are rare. It therefore appears that spikes and seizures are two quite distinct phenomena, both originating in the epileptic focus but varying over time differently from what is most often believed.
局灶性起源的癫痫发作通常像发作间期棘波一样不可预测地发生。人们常常认为，在局灶性起源的癫痫发作之前棘波会增加，并且抗癫痫药物以平行方式影响棘波和癫痫发作。我们回顾了证据，表明这一假设是无效的，并且棘波和癫痫发作之间存在明显的分离：癫痫发作前棘波增加尚未得到明确记录；抗癫痫药物减少不会直接导致棘波增加；癫痫发作后通常会有棘波的长期增加；最后，棘波频繁时癫痫发作的可能性并不比棘波稀少时更高。因此，似乎棘波和癫痫发作是两种截然不同的现象，两者都起源于癫痫病灶，但随时间变化的方式与通常所认为的不同。
