Pizzo Francesca, Frauscher Birgit, Ferrari-Marinho Taissa, Amiri Mina, Dubeau Francois, Gotman Jean
Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada.
Epilepsy Unit, Careggi Hospital, University of Florence, Florence, Italy.
Brain Topogr. 2016 May;29(3):358-67. doi: 10.1007/s10548-016-0481-7. Epub 2016 Feb 26.
To evaluate the possibility of detecting fast ripples (FRs) on the surface EEG of patients with focal pharmacoresistant epilepsy, and to investigate the relationship between scalp FRs and localization of the seizure onset zone (SOZ). We included 10 patients undergoing combined surface-intracranial EEG with ≥10 spikes in the surface EEG during the first 30 consecutive minutes of N3 sleep. FRs (≥4 consecutive oscillations above 250 Hz with an amplitude clearly exceeding that of the background) on the surface EEG (F3-C3, C3-P3, Fz-Cz, Cz-Pz, F4-C4, C4-P4) were visually marked, and verified by two EEG experts. FRs were categorized as related to the SOZ, if localized in the brain lobe of the SOZ. Low-amplitude FRs with a rate of 0.09/min were found in 6/10 patients: two exhibited events related to the SOZ, three showed no relationship with the SOZ, and in one patient the SOZ was not identified. It may be possible to detect FRs with surface EEG using subdermal electrodes in patients with focal epilepsy. The relationship between surface FRs and the SOZ remains unclear. Future studies aiming at a higher spatial EEG coverage are needed to elucidate their significance.
评估在局灶性药物难治性癫痫患者的头皮脑电图（EEG）上检测快速涟漪（FRs）的可能性，并研究头皮FRs与癫痫发作起始区（SOZ）定位之间的关系。我们纳入了10例接受联合头皮-颅内EEG检查的患者，在N3睡眠的前30分钟连续记录中，头皮EEG有≥10个棘波。对头皮EEG（F3-C3、C3-P3、Fz-Cz、Cz-Pz、F4-C4、C4-P4）上的FRs（≥4个连续振荡，频率高于250Hz，幅度明显超过背景）进行视觉标记，并由两名EEG专家进行验证。如果FRs定位于SOZ所在的脑叶，则将其分类为与SOZ相关。6/10例患者发现低幅FRs，发生率为0.09/分钟：2例表现出与SOZ相关的事件，3例与SOZ无相关性，1例未明确SOZ。对于局灶性癫痫患者，使用皮下电极通过头皮EEG检测FRs是可能的。头皮FRs与SOZ之间的关系仍不清楚。需要未来旨在提高EEG空间覆盖范围的研究来阐明它们的意义。
