Department of Neurology, Mayo Systems Electrophysiology Laboratory, Mayo Clinic, 200 First Street SW, Rochester, MN 55901, USA.
Brain. 2010 Sep;133(9):2789-97. doi: 10.1093/brain/awq190. Epub 2010 Aug 4.
Focal seizures appear to start abruptly and unpredictably when recorded from volumes of brain probed by clinical intracranial electroencephalograms. To investigate the spatiotemporal scale of focal epilepsy, wide-bandwidth electrophysiological recordings were obtained using clinical macro- and research microelectrodes in patients with epilepsy and control subjects with intractable facial pain. Seizure-like events not detectable on clinical macroelectrodes were observed on isolated microelectrodes. These 'microseizures' were sparsely distributed, more frequent in brain regions that generated seizures, and sporadically evolved into large-scale clinical seizures. Rare microseizures observed in control patients suggest that this phenomenon is ubiquitous, but their density distinguishes normal from epileptic brain. Epileptogenesis may involve the creation of these topographically fractured microdomains and ictogenesis (seizure generation), the dynamics of their interaction and spread.
从临床颅内脑电图探测的脑区记录到的局灶性发作似乎会突然且不可预测地开始。为了研究局灶性癫痫的时空尺度,我们使用临床宏观和研究微电极在癫痫患者和难治性面部疼痛的对照受试者中获得了宽带生理记录。在临床宏观电极上无法检测到的类似癫痫发作的事件在孤立的微电极上被观察到。这些“微发作”分布稀疏,在引发癫痫发作的脑区更为频繁,并且偶尔会演变成大规模的临床癫痫发作。在对照患者中观察到的罕见微发作表明这种现象是普遍存在的,但它们的密度可以区分正常和癫痫大脑。癫痫发生可能涉及这些地形破碎的微域的产生以及发作发生(癫痫发作的产生)、它们相互作用和传播的动力学。