Mikol F, Monge-Strauss M F
Fondation Rothschild, Service de Neurologie, Paris.
Rev Neurol (Paris). 1987;143(5):451-6.
The purpose of the present study was to determine whether paroxysmal EEG activity (PA) occurs randomly over time and whether seizures arise at time of maximum PA. 204 ambulatory recordings (A/EEG) in 197 adult epileptic outpatients have been were included. The patients' seizures were grouped according to ILAE classification: Simple partial seizures; complex partial seizures (CPS), isolated or secondarily generalized; idiopathic generalized seizures: epilepsy with myoclonic absences, generalized tonic-clonic seizures (GTCS) on awakening, GTCS with photo-sensitivity; undetermined epilepsies: "grand mal morpheique", epilepsies with generalized PA without photosensitivity or with All recordings were performed with a 8-channel 24 h cassette recorder system (Medilog 9,000). The video play-back speed used was 20 times the recording speed to allow good detection, characterization and localization of PA. Counting was accomplished by visual analysis. No PA during A/EEG was noted in 24.5 p. 100 of all cases. A diurnal distribution in wakefulness was found in 59 p. 100 of idiopathic generalized epilepsies, PA usually occurring on awakening whatever the specific time of day; in 27 p. 100 of CPS and 20 p. 100 of undetermined epilepsies, with peak PA occurrence at late morning and 6 pm. During resting-state and afternoon-naps, PA occurrence was mainly seen in CPS. PA occurring only in overnight sleep was observed in 17 p. 100 of CPS and 20 p. 100 of undetermined epilepsies. PA distribution pattern in both CPS and undetermined epilepsies suggests an ultradian rhythm (time-dependent). On the other hand, PA pattern in idiopathic generalized epilepsies support the hypothesis of a circadian rhythm linked to sleep/wake--or light/dark--cycle (state-dependent).
本研究的目的是确定阵发性脑电图活动（PA）是否随时间随机出现，以及癫痫发作是否在PA最大值时发生。纳入了197例成年癫痫门诊患者的204份动态脑电图记录（A/EEG）。患者的癫痫发作根据国际抗癫痫联盟（ILAE）分类进行分组：简单部分性发作；复杂部分性发作（CPS），孤立性或继发性全身性发作；特发性全身性发作：伴有肌阵挛失神的癫痫、觉醒时全身性强直阵挛发作（GTCS）、伴有光敏性的GTCS；未分类癫痫：“形态性大发作”、无光敏性或伴有全身性PA的癫痫。所有记录均使用8通道24小时盒式磁带记录系统（Medilog 9000）进行。所用的视频回放速度是记录速度的20倍，以便对PA进行良好的检测、特征描述和定位。计数通过视觉分析完成。在所有病例的24.5%中，A/EEG期间未观察到PA。在59%的特发性全身性癫痫中发现了清醒状态下的日分布情况，无论一天中的具体时间如何，PA通常在觉醒时出现；在27%的CPS和20%的未分类癫痫中，PA在上午晚些时候和下午6点出现峰值。在静息状态和午睡期间，PA主要出现在CPS中。在17%的CPS和20%的未分类癫痫中观察到PA仅在夜间睡眠时出现。CPS和未分类癫痫中的PA分布模式表明存在超日节律（时间依赖性）。另一方面，特发性全身性癫痫中的PA模式支持与睡眠/觉醒或光/暗周期（状态依赖性）相关的昼夜节律假说。
