Sadler R M, Blume W T
Epilepsy Unit, University Hospital, University of Western Ontario, London, Canada.
Epilepsia. 1989 Mar-Apr;30(2):143-6. doi: 10.1111/j.1528-1157.1989.tb05446.x.
We examined the clinical significance of bisynchronous spike-wave complexes which appear in EEGs of some patients with focal spikes in one or both temporal lobes. Few features distinguished patients with bisynchronous spike-waves from those with only focal temporal spikes: a higher incidence of patients with more than two grand mal seizures a year (43 vs. 7%) and a younger age at last recording (22.5 vs. 28.3 years) were the only statistically reliable factors. Proportion of patients with complex partial seizures (CPS) (100%), age of CPS onset, incidence of febrile convulsions, intellectual level, and normal neurologic examination were features common to the two groups. In contrast to other studies which did not exclude influencing variables such as extratemporal spike foci, our group with bisynchronous spike-waves fared equally well after temporal lobectomy as did patients with temporal spikes alone. All 6 patients with spike-waves obtained a reduction of at least 50% in seizure frequency and 5 of the 6 (83%) had a greater than 90% reduction. Sixteen of 17 patients (94%) without spike-waves had a reduction of at least 50% and 14 of the 17 (82%) had a greater than 90% reduction of seizures.
我们研究了双同步棘波复合波在部分一侧或双侧颞叶有局灶性棘波的患者脑电图中的临床意义。双同步棘波患者与仅有颞叶局灶性棘波的患者之间几乎没有显著差异：每年癫痫大发作超过两次的患者发生率较高（43%对7%）以及末次记录时年龄较小（22.5岁对28.3岁）是仅有的统计学上可靠的因素。两组患者的复杂部分性发作（CPS）比例（100%）、CPS起病年龄、热性惊厥发生率、智力水平以及神经系统检查正常等特征并无差异。与其他未排除颞外棘波灶等影响变量的研究不同，我们的双同步棘波组患者在颞叶切除术后与仅有颞叶棘波的患者预后相当。所有6例有棘波的患者癫痫发作频率至少降低了50%，其中5例（83%）降低超过90%。17例无棘波的患者中有16例（94%）癫痫发作频率至少降低了50%，17例中有14例（82%）降低超过90%。
