Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
Clin EEG Neurosci. 2010 Jul;41(3):143-6. doi: 10.1177/155005941004100307.
The phenomenon of temporal clustering of seizures is well known, but its effect on seizure localization has not been rigorously analyzed. The aim of our study was to assess electrophysiological localization during Video EEG (VEEG) monitoring in patients with intractable epilepsy demonstrating a cluster of seizures. The study was conducted on 203 intractable epilepsy patients, aged 2 to 60 years (19.96 +/- 10.87). Patients with unilateral temporal lobe epilepsy having clusters were compared with patients not having clusters, and the effect of clustering on concordance was addressed. Fully consistent localization was observed in 116 patients, partially consistent localization in 18 patients, and inconsistent localization in 19 patients. ANOVA did not reveal any significant difference in these groups (p=0.65). A total of 770 seizures recorded from 149 patients was analyzed for clustering effect. Clustering was present in 603/770 seizures pairs (78.31%). In the cluster group, 483 (80.09%) seizure pairs were concordant for seizure onset, while 98 (16.25%) were discordant and 22 (3.65%) were indeterminate. In the noncluster group, 134 (80.24%) seizure pairs were concordant for seizure onset, while 23 (13.77%) were discordant and 10 (5.98%) were indeterminate. The study found that cluster seizures occurring within an interseizure interval (ISI) less than 8 hours are independent and have the same localizing value as those seizures with longer ISIs.
癫痫发作的时间聚集现象是众所周知的，但它对癫痫灶定位的影响尚未得到严格分析。我们的研究旨在评估在具有癫痫发作聚集的耐药性癫痫患者的视频脑电图（VEEG）监测中进行电生理定位。该研究共纳入 203 例年龄在 2 至 60 岁之间（19.96 +/- 10.87）的耐药性癫痫患者。我们将单侧颞叶癫痫且具有发作聚集的患者与不具有发作聚集的患者进行比较，并探讨了发作聚集对一致性的影响。116 例患者的定位完全一致，18 例患者的定位部分一致，19 例患者的定位不一致。方差分析显示这些组之间没有显著差异（p=0.65）。对来自 149 例患者的总共 770 例癫痫发作进行聚类效果分析。在 770 对癫痫发作中，有 603 对（78.31%）存在聚集。在聚集组中，483 对（80.09%）癫痫发作起始部位一致，98 对（16.25%）不一致，22 对（3.65%）不确定。在非聚集组中，134 对（80.24%）癫痫发作起始部位一致，23 对（13.77%）不一致，10 对（5.98%）不确定。该研究发现，发作间期（ISI）小于 8 小时的簇状癫痫发作是独立的，与 ISI 较长的癫痫发作具有相同的定位价值。
