Department of Child Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences and Okayama University Hospital, Okayama, Japan.
Department of Child Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences and Okayama University Hospital, Okayama, Japan; Department of Child Neurology, NHO Minami-Okayama Medical Center, Okayama, Okayama, Japan.
Brain Dev. 2020 Oct;42(9):663-674. doi: 10.1016/j.braindev.2020.06.001. Epub 2020 Jul 4.
Epilepsy associated with tuberous sclerosis complex (TSC) has very complex clinical characteristics. Scalp electroencephalogram (EEG) fast (40-200 Hz) oscillations (FOs) were recently suggested to indicate epilepsy severity. Epileptic FOs may undergo age-dependent longitudinal change in individual patients, however, and the typical pattern of such change is not yet fully clarified. We therefore investigated the age-related correspondence between clinical courses and FOs in pediatric patients with TSC-associated epilepsy.
FOs were semi-automatically detected from scalp sleep EEG data recorded from 23 children (15 boys, 8 girls; initial data obtained at <10 years of age) with TSC-associated epilepsy.
The number of FOs per patient that were associated with spikes was significantly greater than that of FOs unassociated with spikes (median 145 and 5, respectively; p = 0.0001 by the Wilcoxon signed-rank test). In the eight patients who had West syndrome (WS) in infancy, FOs associated with spikes were abundant during the WS period prior to adrenocorticotropic hormone therapy, with significantly greater numbers of FOs compared to the post-WS period (median 242 and 0, respectively; p = 0.0078). As there was no such time-dependent difference regarding FOs unassociated with spikes, FOs associated with spikes were identified as epileptic. The detected FOs included both gamma and ripple oscillations with no consistent age-dependent shifts in dominant frequency. There were no apparent age-related changes in FO duration.
Epileptic scalp FOs are confirmed to correspond to severity of epileptic encephalopathy, particularly in WS, even during the long-term evolutional courses of TSC-associated epilepsy.
与结节性硬化症复合征（TSC）相关的癫痫具有非常复杂的临床特征。最近有研究提出，头皮脑电图（EEG）快（40-200 Hz）振荡（FOs）可以指示癫痫严重程度。然而，癫痫患者的 FO 可能会随着年龄发生纵向变化，并且这种变化的典型模式尚未完全阐明。因此，我们研究了患有 TSC 相关癫痫的儿科患者的临床病程与 FO 之间的年龄相关性。
从 23 例患有 TSC 相关癫痫的儿童（15 名男性，8 名女性；初始数据采集年龄<10 岁）的头皮睡眠 EEG 数据中半自动检测到 FO。
与棘波相关的每个患者的 FO 数量明显多于与棘波无关的 FO（中位数分别为 145 和 5；Wilcoxon 符号秩检验，p=0.0001）。在 8 例婴儿期患有 West 综合征（WS）的患者中，在促肾上腺皮质激素治疗前的 WS 期间，与棘波相关的 FO 丰富，与 WS 后相比，FO 数量明显更多（中位数分别为 242 和 0；p=0.0078）。由于与棘波无关的 FO 没有这种时间依赖性差异，因此将与棘波相关的 FO 确定为癫痫性。检测到的 FO 包括γ和涟漪振荡，其主频没有一致的年龄依赖性变化。FO 持续时间没有明显的年龄相关变化。
癫痫性头皮 FO 被证实与癫痫性脑病的严重程度相对应，特别是在 WS 中，即使在 TSC 相关癫痫的长期演变过程中也是如此。
