Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan.
Epilepsy Res. 2012 Nov;102(1-2):60-70. doi: 10.1016/j.eplepsyres.2012.04.020. Epub 2012 May 29.
High-frequency oscillations (HFOs) on intracranial electroencephalography (EEG) recordings have been reported to be useful to identify the epileptogenic zone in intractable epilepsy. We investigated whether the ictal HFOs on scalp EEG seen during spasms contributed to identification of the epileptogenic zone in symptomatic West syndrome (S-WS).
In S-WS, ictal scalp EEGs were recorded during a series of spasms. The HFOs associated with spasms were visualized in the temporally expanded EEG traces and subjected to time-frequency analysis. The results on the distribution of HFOs were compared with that of cortical lesions indicated by neuroimaging.
In the 4 children examined, HFOs at 80-150 Hz preceded the clinical onsets of spasms. The maximum augmentation of these HFOs was larger than that of HFOs at 20-70 Hz. The regions of the maximum augmentation of HFOs at 80-150 Hz were identical to the lesions detected by neuroimaging. Two patients who underwent dissection of the area including the area with HFOs resulted in Engel class I.
Ictal HFOs of spasms on scalp EEG showed a strong association with neuroimaging abnormalities presumed to be the epileptogenic zone in S-WS. Ictal HFOs can thus be a useful marker for exploring lesions for epilepsy surgery.
颅内脑电图（EEG）记录中的高频振荡（HFOs）已被报道有助于识别耐药性癫痫的致痫区。我们研究了在痉挛期间看到的头皮 EEG 上的发作期 HFO 是否有助于确定症状性 West 综合征（S-WS）的致痫区。
在 S-WS 中，在一系列痉挛期间记录发作期头皮 EEG。在时间扩展的 EEG 迹线上可视化与痉挛相关的 HFO，并进行时频分析。将 HFO 分布的结果与神经影像学所示的皮质病变进行比较。
在 4 名接受检查的儿童中，80-150 Hz 的 HFO 先于痉挛的临床发作。这些 HFO 的最大增强大于 20-70 Hz 的 HFO。80-150 Hz 的 HFO 最大增强区域与神经影像学检测到的病变相同。接受包括 HFO 区域在内的区域解剖的 2 名患者的 Engel 分级为 I 级。
头皮 EEG 上的痉挛发作期 HFO 与神经影像学异常强烈相关，这些异常被认为是 S-WS 的致痫区。因此，发作期 HFO 可以成为探索癫痫手术病变的有用标志物。
