Department of Clinical Neurophysiology, Ronald Reagan UCLA Medical Center, Los Angeles, CA 90095, USA.
Clin Neurophysiol. 2012 Mar;123(3):471-85. doi: 10.1016/j.clinph.2011.08.007. Epub 2011 Sep 7.
To demonstrate if interictal spike activity was localized within the resected area in surgically treated epilepsy patients; and if there is correspondence between the degree of localization and improvement after surgery.
We analyzed long-term EEGs from 34 patients. Interictal spikes were grouped in clusters and averaged according to morphology and topography. The relative contribution of each cluster to the total number of spikes in each patient was estimated. Dipole and distributed EEG source localization of each cluster was made. The percentage of spike activity localized within the site of resection (SR) during the onset was estimated. The relationship between the percentage of activity within SR and the surgery outcome was assessed.
Fourteen patients had 90-100% of spikes within SR, 9 had 50-89%. Most patients with more than 50% of activity localized within SR were seizure free, while the 5 patients who had all activity localized outside SR were not seizure free.
Localization of clusters containing the largest quantity of interictal spikes during onset generally corresponded to the likely location of the epileptogenic cortex.
Computer-assisted EEG source localization with our methodology can be a useful adjunct for the evaluation of candidates for epilepsy surgery.
在接受手术治疗的癫痫患者中，证明发作间期棘波活动是否局限于切除区域；以及定位程度与术后改善是否存在对应关系。
我们分析了 34 例患者的长程 EEG。根据形态和拓扑结构将发作间期棘波分组并进行平均。估计每个患者每个簇相对于总棘波数的相对贡献。对每个簇进行偶极子和分布式 EEG 源定位。估计棘波活动在起始时位于切除部位（SR）内的百分比。评估 SR 内活动百分比与手术结果之间的关系。
14 例患者的棘波有 90-100%位于 SR 内，9 例有 50-89%。大多数 SR 内活动超过 50%的患者无癫痫发作，而 5 例所有活动均位于 SR 外的患者仍有癫痫发作。
发作起始时包含最大数量发作间期棘波的簇的定位通常与致痫皮质的可能位置相对应。
我们的方法学通过计算机辅助 EEG 源定位，可以作为评估癫痫手术候选者的有用辅助手段。
