Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Naka-ku, Hamamatsu, Shizuoka 430-8558, Japan.
Epilepsy Res. 2012 Feb;98(2-3):166-73. doi: 10.1016/j.eplepsyres.2011.09.007. Epub 2011 Oct 20.
To evaluate the clinical utility of dense array electroencephalography (dEEG) for the detection yield and localization of interictal spikes in mesial temporal lobe epilepsy.
We simultaneously recorded 256-channel dEEG and intracranial electroencephalography (icEEG) implanted over the lateral and mesial temporal lobe in patients with intractable epilepsy. We calculated the dEEG spike detection rate for mesial temporal spikes which were confirmed by icEEG and applied source estimation to dEEG to compare noninvasive localization to the invasive recordings.
339 of 760 interictal spikes (45%) were detected by dEEG examining the 256-channel head surface array. The average icEEG amplitude of dEEG detectable spikes was 1083 μV, and that of dEEG undetectable spikes was 780 μV (P<0.05). All spikes detected in dEEG were localized to the temporal lobe. 295 of 339 spikes (87%) were well localized in mesial temporal lobe, close to the position confirmed by subdural electrodes.
256-channel dEEG may provide more precise information for the localization of interictal epileptiform discharges than conventional EEG or MEG in patients with deep spike foci. 256-channel dEEG may be clinically useful in the presurgical work-up for epilepsy, providing accurate noninvasive guidance for the placement of intracranial electrodes.
评估密集电极脑电图（dEEG）在检测内侧颞叶癫痫（MTLE）发作间期棘波的检出率和定位中的临床应用。
我们在难治性癫痫患者的外侧和内侧颞叶同时记录了 256 通道 dEEG 和颅内脑电图（icEEG）。我们计算了内侧颞叶棘波的 dEEG 棘波检出率，这些棘波通过 icEEG 证实，并应用源估计对 dEEG 进行了分析，比较了非侵入性定位与侵入性记录。
在 256 通道头部表面阵列中检查了 760 个发作间期棘波中的 339 个（45%）被 dEEG 检测到。dEEG 可检测棘波的平均 icEEG 幅度为 1083μV，而 dEEG 不可检测棘波的平均幅度为 780μV（P<0.05）。dEEG 检测到的所有棘波均定位于颞叶。339 个棘波中的 295 个（87%）在颞叶深部被很好地定位，接近硬膜下电极证实的位置。
与常规 EEG 或 MEG 相比，256 通道 dEEG 可能为深部棘波灶患者的发作间期癫痫样放电的定位提供更精确的信息。256 通道 dEEG 在癫痫的术前评估中可能具有临床应用价值，为颅内电极的放置提供准确的非侵入性指导。
