Leal Alberto J R, Ferreira José C, Dias Ana I, Calado Eulália
Department of Neurophysiology, Hospital Júlio de Matos, Av(a) do Brasil nr 53, 1749-002 Lisbon, Portugal.
Clin Neurophysiol. 2008 Sep;119(9):1985-91. doi: 10.1016/j.clinph.2008.04.299. Epub 2008 Jul 11.
Early onset benign occipital lobe epilepsy (Panayiotopoulos syndrome [PS]) is a common and easily recognizable epilepsy. Interictal EEG spike activity is often multifocal but most frequently localized in the occipital lobes. The origin and clinical significance of the extra-occipital spikes remain poorly understood.
Three patients with the PS and interictal EEG spikes with frontal lobe topography were studied using high-resolution EEG. Independent component analysis (ICA) was used to decompose the spikes in components with distinct temporal dynamics. The components were mapped in the scalp with a spline-laplacian algorithm.
The change in scalp potential topography from spike onset to peak, suggests the contribution of several intracranial generators, with different kinetics of activation and significant overlap. ICA was able to separate the major contributors to frontal spikes and consistently revealed an early activating group of components over the occipital areas in all the patients. The local origin of these early potentials was established by the spline-laplacian montage.
Frontal spikes in PS are consistently associated with early and unilateral occipital lobe activation, suggesting a postero-anterior spike propagation.
Frontal spikes in the PS represent a secondary activation triggered by occipital interictal discharges and do not represent an independent focus.
早发性良性枕叶癫痫（帕纳约托普洛斯综合征[PS]）是一种常见且易于识别的癫痫。发作间期脑电图棘波活动通常是多灶性的，但最常局限于枕叶。枕叶外棘波的起源和临床意义仍知之甚少。
对3例患有PS且发作间期脑电图棘波具有额叶地形图的患者进行了高分辨率脑电图研究。使用独立成分分析（ICA）将棘波分解为具有不同时间动态的成分。采用样条-拉普拉斯算法将这些成分映射到头皮上。
从棘波起始到峰值头皮电位地形图的变化表明，有几个颅内发生器参与其中，它们具有不同的激活动力学且有显著重叠。ICA能够分离出额叶棘波的主要贡献者，并在所有患者中始终显示出枕叶区域早期激活的一组成分。这些早期电位的局部起源通过样条-拉普拉斯蒙太奇法得以确定。
PS中的额叶棘波始终与早期单侧枕叶激活相关，提示从后向前的棘波传播。
PS中的额叶棘波代表由枕叶发作间期放电触发的继发性激活，而非独立病灶。
