Puce A, Kalnins R M, Berkovic S F, Donnan G A, Bladin P F
Department of Neurology, Austin Hospital, Victoria, Australia.
Ann Neurol. 1989 Sep;26(3):377-85. doi: 10.1002/ana.410260311.
Limbic P3 event-related potentials were recorded from mesial temporal electrodes implanted for presurgical investigation in 70 patients with intractable focal seizures. In 46 (81%) of 57 patients with unilateral temporal lobe epilepsy, the limbic P3 potential was absent or rudimentary ipsilateral to the seizure focus and a robust P3 potential was always elicited from the nonepileptogenic temporal lobe. Bilateral P3 potentials were recorded in 6 patients (10%) with unilateral temporal lobe epilepsy. In the remaining 5 patients in the group with unilateral temporal lobe epilepsy, results showed P3 bilaterally absent (2 patients), P3 present in a unilateral investigation (1 patient), P3 absent contralateral to the seizure focus (1 patient), and technically unsatisfactory recordings (1 patient). Bilaterally absent P3 potentials were noted in 2 patients with bilateral temporal lobe epilepsy. In 6 patients with technically adequate P3 studies and extratemporal seizures, bilaterally present P3 potentials were noted. Sensitivity and specificity of P3 absence as a predictor of an epileptogenic temporal lobe were 87% and 95%, respectively. Tissue specimens of the hippocampus were available in 22 patients (43%). Thirteen hippocampi showed sclerosis, all of which were associated with unilaterally absent P3 potentials. Nine hippocampi were normal (5 patients with the P3 absent, 4 with P3 present). Sensitivity and specificity of an absent limbic P3 as a function of hippocampal pathological findings were 100% and 44%, respectively. Absent limbic P3 potentials in temporal lobe epilepsy thus indicate structural or functional hippocampal abnormality and may add important information in presurgical evaluation with depth electrodes of patients who have temporal lobe epilepsy.
对70例顽固性局灶性癫痫患者进行术前检查时，通过植入内侧颞叶电极记录边缘系统P3事件相关电位。在57例单侧颞叶癫痫患者中，46例（81%）癫痫灶同侧的边缘系统P3电位缺失或发育不全，而非癫痫性颞叶总能引出强P3电位。6例（10%）单侧颞叶癫痫患者记录到双侧P3电位。在单侧颞叶癫痫组其余5例患者中，结果显示双侧P3电位缺失（2例）、单侧检查时P3电位存在（1例）、癫痫灶对侧P3电位缺失（1例）以及记录技术上不满意（1例）。2例双侧颞叶癫痫患者记录到双侧P3电位缺失。在6例P3研究技术上合适且有颞叶外癫痫发作的患者中，记录到双侧P3电位存在。P3电位缺失作为癫痫性颞叶预测指标的敏感性和特异性分别为87%和95%。22例患者（43%）有海马组织标本。13个海马显示硬化，所有这些均与单侧P3电位缺失有关。9个海马正常（5例P3电位缺失，4例P3电位存在）。边缘系统P3电位缺失作为海马病理结果的函数，其敏感性和特异性分别为100%和44%。因此，颞叶癫痫中边缘系统P3电位缺失表明海马存在结构或功能异常，并且可能为颞叶癫痫患者术前深度电极评估增加重要信息。
