Sperling M R, O'Connor M J
Comprehensive Epilepsy Center, Graduate Hospital, Philadelphia, PA 19146.
Neurology. 1989 Nov;39(11):1497-504. doi: 10.1212/wnl.39.11.1497.
Intracranial EEG recording is often required to identify an area of the brain for resective surgery for intractable epilepsy. We simultaneously compared bilaterally placed depth and limited subdural electrode EEG to determine the most effective method of recording seizures from the temporal lobes. Localized complex partial seizures usually appeared earlier in hippocampal depth electrodes and spread later to subdural recording sites. In 3 patients, hippocampal recordings showed localized seizure origin but subdural recording was nonlocalizing due to rapid bilateral seizure propagation. In 1 patient with nonlocalized seizures presumably of extratemporal origin, subdural electrodes incorrectly lateralized seizure origin to a temporal lobe. Auras and subclinical seizures detected by depth electrode recording were often not evident with subdural electrodes. We conclude that EEG recording with hippocampal depth electrodes correctly identifies and lateralizes temporal lobe seizures more often than with limited subdural electrodes.
对于难治性癫痫的切除性手术，通常需要进行颅内脑电图（EEG）记录以确定大脑中的一个区域。我们同时比较了双侧放置的深部电极和有限的硬膜下电极脑电图，以确定从颞叶记录癫痫发作的最有效方法。局限性复杂部分性发作通常在海马深部电极中出现得更早，随后扩散到硬膜下记录部位。在3例患者中，海马记录显示癫痫发作起源局限，但由于癫痫发作快速双侧传播，硬膜下记录未能定位。在1例推测为颞叶外起源的非局限性癫痫发作患者中，硬膜下电极将癫痫发作起源错误地定位于颞叶。深部电极记录检测到的先兆和亚临床发作在硬膜下电极记录时往往不明显。我们得出结论，与有限的硬膜下电极相比，海马深部电极进行脑电图记录能更频繁地正确识别和定位颞叶癫痫发作。
