颞叶癫痫的发作间期颅内癫痫起始的估计。

Interictal estimation of intracranial seizure onset in temporal lobe epilepsy.

机构信息

Department of Clinical Neuroscience, King's College London, Institute of Psychiatry, UK; Department of Clinical Neurophysiology, King's College Hospital, London, UK.

Department of Clinical Neuroscience, King's College London, Institute of Psychiatry, UK; Department of Clinical Neurophysiology, King's College Hospital, London, UK; Departamento de Fisiología, Facultad de Medicina, Universidad Complutense, Madrid, Spain.

出版信息

Clin Neurophysiol. 2014 Feb;125(2):231-8. doi: 10.1016/j.clinph.2013.07.008. Epub 2013 Aug 21.

DOI:10.1016/j.clinph.2013.07.008

PMID:23972389

Abstract

OBJECTIVES

To evaluate the lateralizing and localizing values of interictal focal slow activity (IFSA), single pulse electrical stimulation (SPES) and (18)FDG PET, in order to estimate their potential to complement ictal intracranial recordings and reduce prolonged monitoring in patients with temporal lobe epilepsy.

METHODS

The study includes 30 consecutive patients with bilateral temporal subdural electrodes and focal seizure onset. IFSA, SPES and (18)FDG PET when available, were visually assessed and their combined lateralization was based on the majority of the individual lateralizing tests.

RESULTS

In the 18 patients who had all three tests, lateralization was congruent with seizure onset areas in 15 (83%). When lateralized (15 patients), (18)FDG PET was always congruent with intracranial seizure onset. In all 12 patients without (18)FDG PET, lateralization combining IFSA and SPES was congruent with seizure onset, including two with bilateral independent seizure onset on subdural monitoring. 22 out of the 23 patients who had surgery enjoyed favorable outcome (Engel I or II).

CONCLUSION

Intracranial IFSA and SPES can reliably predict the side and site (mesial versus lateral temporal) of seizure onset when they lateralize to the same side.

SIGNIFICANCE

(18)FDG PET can be useful in planning electrode implantation. During intracranial recordings, IFSA and SPES have the potential to reduce telemetry time, risks and costs.

摘要

目的

评估发作间期局灶性慢活动（IFSA）、单次电刺激（SPES）和（18）FDG PET 的定位和定位价值，以评估它们在补充发作期颅内记录和减少颞叶癫痫患者长时间监测方面的潜力。

方法

本研究纳入了 30 例双侧颞叶硬膜下电极和局灶性发作起始的连续患者。IFSA、SPES 和（18）FDG PET（如有）进行了视觉评估，其联合定位基于大多数个体定位测试的多数。

结果

在 18 例进行了所有三项测试的患者中，15 例（83%）的定位与发作起始区域一致。当（15 例）定位时，（18）FDG PET 始终与颅内发作起始一致。在所有 12 例未进行（18）FDG PET 的患者中，结合 IFSA 和 SPES 的定位与发作起始一致，包括 2 例在硬膜下监测时双侧独立发作起始。23 例接受手术的患者中有 22 例预后良好（Engel I 或 II）。