Department of Pediatrics, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
Clin Neurophysiol. 2011 May;122(5):869-73. doi: 10.1016/j.clinph.2010.09.026. Epub 2010 Nov 24.
Peri-rolandic spikes are typically seen in benign childhood epilepsy with centro-temporal spikes. However, some cases of epilepsy with peri-rolandic spikes manifest with medical intractability or cognitive dysfunction. The present study evaluated whether spike source localization is predictive of different prognosis of epilepsy and/or cognitive function.
The localization of peri-rolandic spikes was compared between 6 patients whose seizure remitted under age of 15 years with no cognitive impairment (benign group) and 6 patients with either intractable epilepsy or cognitive dysfunction (non-benign group). The sources of epileptic spikes were approximated by the single equivalent current dipole (ECD) model using whole-head magnetoencephalography.
The spike locations in the benign group were significantly lateral (14.8±5.3 versus 5.3±3.3 mm, p<0.05), anterior (11.6±2.1 versus 3.7±4.8 mm, p<0.01), and inferior (27.7±3.6 versus 12.0±10.0 mm, p<0.01) to those in the non-benign group. Seizures tended to involve the laryngo-pharyngo-oro-facial area in the benign group and the facial-hand-foot area in the non-benign group.
The clear difference in spike dipole location between benign group and non-benign groups.
Spike localization may be useful for predicting prognosis in epilepsy with sensorimotor seizures and spikes along with central sulcus.
中央颞区棘波良性儿童癫痫通常伴有额-中央区棘波。然而，一些额-中央区棘波癫痫患者表现出药物难治性或认知功能障碍。本研究评估了棘波源定位是否能预测癫痫和/或认知功能的不同预后。
比较了 6 例年龄在 15 岁以下且无认知障碍的癫痫发作缓解患者（良性组）和 6 例药物难治性癫痫或认知功能障碍患者（非良性组）的额-中央区棘波定位。使用全头脑磁图近似单等效电流偶极子（ECD）模型来定位癫痫棘波的源。
良性组的棘波位置明显更靠外侧（14.8±5.3 比 5.3±3.3 毫米，p<0.05）、更靠前（11.6±2.1 比 3.7±4.8 毫米，p<0.01）和更低（27.7±3.6 比 12.0±10.0 毫米，p<0.01）。良性组的癫痫发作倾向于累及喉-咽-口-面区，而非良性组的癫痫发作倾向于累及面-手-足区。
良性组和非良性组的棘波偶极子位置存在明显差异。
棘波定位对于预测伴有中央沟棘波的感觉运动性癫痫的预后可能有用。
