Inoue Takeshi, Inouchi Morito, Matsuhashi Masao, Matsumoto Riki, Hitomi Takefumi, Daifu-Kobayashi Masako, Kobayashi Katsuya, Nakatani Mitsuyoshi, Kanazawa Kyoko, Shimotake Akihiro, Kikuchi Takayuki, Yoshida Kazumichi, Kunieda Takeharu, Miyamoto Susumu, Takahashi Ryosuke, Ikeda Akio
Department of Neurology, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto, Japan.
Department of Respiratory Care and Sleep Control Medicine, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto, Japan.
J Clin Neurophysiol. 2019 Mar;36(2):166-170. doi: 10.1097/WNP.0000000000000527.
We reported the presence of interictal slow and high-frequency oscillations (HFOs) (IIS + HFO) and its temporal change so as to elucidate its clinical usefulness as a surrogate marker of epileptogenic zone in a patient with intractable focal epilepsy.
We focused on one of the core electrodes of epileptogenicity, and investigated IIS + HFO in the pre- and post-segment of 30 minutes to all the 6 seizures. We adopted interictal slow in duration of 0.33 to 10 seconds, amplitude ≥50 μV and co-occurring with HFOs, and then divided into 5 groups depending on the amplitude of slow wave.
Before and after all the 6 seizures, the number of IIS + HFO was 2,890 at one electrode in the core epileptogenic zone. The number of IIS + HFO significantly decreased for 30 minutes after seizures. Furthermore, the number of IIS + HFO with the amplitude of 200 to 399 μV significantly decreased after seizures.
IIS + HFO with the amplitude of 200 to 399 μV was influenced by and decreased after seizures. It may reflect the core part of epileptogenic area as similarly as ictal direct current shifts and ictal HFOs do. IIS + HFO could be called as the term "red slow," which may be useful to delineate at least a part of the epileptogenic zone.
我们报告发作间期慢波和高频振荡（HFOs）（IIS + HFO）的存在及其时间变化，以阐明其作为难治性局灶性癫痫患者致痫区替代标志物的临床实用性。
我们聚焦于致痫性的核心电极之一，对所有6次发作的30分钟前后段进行IIS + HFO研究。我们采用持续时间为0.33至10秒、幅度≥50 μV且与HFOs同时出现的发作间期慢波，然后根据慢波幅度分为5组。
在所有6次发作前后，致痫核心区一个电极处的IIS + HFO数量为2890次。发作后30分钟内，IIS + HFO数量显著减少。此外，幅度为200至399 μV的IIS + HFO数量在发作后也显著减少。
幅度为200至399 μV的IIS + HFO受发作影响且发作后减少。它可能与发作期直流偏移和发作期HFOs一样反映致痫区域的核心部分。IIS + HFO可被称为“红色慢波”，这可能有助于勾勒至少一部分致痫区。
