Department of Neurology, Mayo Clinic, Jacksonville, FL 32224, USA.
J Clin Neurophysiol. 2012 Oct;29(5):356-65. doi: 10.1097/WNP.0b013e31826b3ab7.
Temporal lobe epilepsy (TLE) is the most common form of adult localization-related epilepsy. Hippocampal onset accounts for at least 80% of all temporal lobe seizures. The electroencephalogram (EEG) of mesial TLE contains interictal features often associated with anterior temporal epileptiform discharges with a maximal voltage over the basal temporal electrodes. Localized ictal patterns on scalp EEGs characteristically reveal unilateral 5- to 9-Hz rhythmic ictal theta or alpha epileptiform activity maximal in the anterior temporal scalp electrodes. Invasive-scalp EEG comparisons have yielded direct information about mesial temporal sources and their corresponding electrical fields. Refinement of macroscopic spatial and the temporal resolution suggest that a more precise seizure localization may exist beyond 1- to 35-Hz frequencies observed in routine scalp recording. Defining the focal areas of ictogenesis within the medial temporal lobe demonstrates a rich connection to a broad network that goes beyond the medial structures and even the temporal lobe itself. Advanced electrophysiologic application in TLE may further our understanding of ictogenesis to perfect surgical treatment and to elucidate the neurophysiologic corollaries of epileptogensis itself.
颞叶癫痫（TLE）是成人局灶性相关癫痫中最常见的形式。海马起源至少占所有颞叶发作的 80%。内侧 TLE 的脑电图（EEG）包含与前颞叶癫痫样放电相关的发作间期特征，在基底颞部电极上具有最大电压。头皮 EEG 上的局灶性发作模式特征性地揭示单侧 5-9 Hz 节律性发作性 theta 或 alpha 癫痫样活动，在前颞头皮电极上最大。头皮 EEG 的侵入性比较提供了关于内侧颞叶源及其相应电场的直接信息。宏观空间和时间分辨率的细化表明，在常规头皮记录中观察到的 1-35 Hz 频率之外，可能存在更精确的发作定位。在内侧颞叶内确定致痫灶的焦点区域表明，与广泛网络的联系非常丰富，不仅包括内侧结构，甚至包括颞叶本身。TLE 中的高级电生理应用可能会进一步了解致痫机制，以完善手术治疗，并阐明癫痫发生本身的神经生理后果。
