R. Madhavan Nayar Center for Comprehensive Epilepsy Care, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences & Technology, Trivandrum, Kerala, India.
R. Madhavan Nayar Center for Comprehensive Epilepsy Care, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences & Technology, Trivandrum, Kerala, India.
Clin Neurophysiol. 2018 May;129(5):946-951. doi: 10.1016/j.clinph.2018.02.007. Epub 2018 Feb 27.
Interictal regional paroxysmal fast activity (RPFA) on scalp EEG is common in patients with focal cortical dysplasia (FCD). Little data exists regarding the presence of RPFA in other etiologies.
We studied the association between RPFA and etiology on MRI in patients with drug resistant focal epilepsy undergoing presurgical evaluation in 2011. RPFA was defined as ≥3 consecutive spikes with a frequency of ≥10 Hz lasting ≥300 ms but <4 s.
626 patients fulfilled the inclusion criteria. Of these, 138 (22%) patients had RPFA while rest had other interictal epileptiform discharges (IEDs). RPFA was located at posterior head region in 52.2% patients, frontal regions in 24.6% patients and over temporal regions in 17.4% patients. Focal gliosis (61, 44%) and FCD (27, 19%) were common etiologies in patients with RPFA. Compared to patients with other IEDs, patients with RPFA were more likely to have focal gliosis (61/138 vs. 39/488; p < 0.0001) or FCD (27/138 vs 37/488; p < 0.001) as the etiology of epilepsy.
In developing countries, focal gliosis is more common than FCD as the underlying etiology in patients with RPFA on scalp EEG.
Focal gliosis should be considered as one of the common substrate for RPFA on scalp EEG.
头皮脑电图上的局灶性皮质发育不良（FCD）患者常出现发作间期局部阵发性快活动（RPFA）。关于其他病因中是否存在 RPFA 的数据很少。
我们研究了 2011 年在接受术前评估的耐药性局灶性癫痫患者中，MRI 上的 RPFA 与病因之间的关系。RPFA 定义为≥3 个连续的棘波，频率≥10 Hz，持续≥300 ms 但<4 s。
626 名患者符合纳入标准。其中，138 名（22%）患者有 RPFA，其余患者有其他发作间期癫痫样放电（IEDs）。RPFA 位于后头部的患者占 52.2%，额部的患者占 24.6%，颞部的患者占 17.4%。局灶性胶质增生（61 例，44%）和 FCD（27 例，19%）是 RPFA 患者的常见病因。与其他 IED 患者相比，RPFA 患者更有可能存在局灶性胶质增生（61/138 与 39/488；p<0.0001）或 FCD（27/138 与 37/488；p<0.001）作为癫痫的病因。
在发展中国家，局灶性胶质增生作为头皮 EEG 上 RPFA 的潜在病因比 FCD 更为常见。
局灶性胶质增生应被视为头皮 EEG 上 RPFA 的常见基础之一。
