Baud Maxime O, Schindler Kaspar, Rao Vikram R
Sleep Wake Epilepsy Center, NeuroTec and Center for Experimental Neurology, Department of Neurology, Inselspital Bern, University Hospital, University of Bern, Switzerland.
Wyss Center for Bio- and Neuro-engineering, Geneva, Switzerland.
Clin Neurophysiol Pract. 2020 Dec 30;6:41-49. doi: 10.1016/j.cnp.2020.12.002. eCollection 2021.
The cyclical structure of epilepsy was recently (re)-discovered through years-long intracranial electroencephalography (EEG) obtained with implanted devices. In this review, we discuss how new revelations from chronic EEG relate to the practice and interpretation of conventional EEG. We argue for an electrographic definition of seizures and highlight the caveats of counting epileptiform discharges in EEG recordings of short duration. Limitations of conventional EEG have practical implications with regard to titrating anti-seizure medications and allowing patients to drive, and we propose that chronic monitoring of brain activity could greatly improve epilepsy care. An impending paradigm shift in epilepsy will involve using next-generation devices for chronic EEG to leverage known biomarkers of disease state.
癫痫的周期性结构最近通过植入设备进行的长达数年的颅内脑电图（EEG）检查得以（重新）发现。在本综述中，我们讨论了慢性脑电图的新发现如何与传统脑电图的实践和解读相关。我们主张对癫痫发作进行电描记学定义，并强调在短程脑电图记录中计数癫痫样放电的注意事项。传统脑电图的局限性在调整抗癫痫药物剂量和允许患者驾驶方面具有实际影响，我们建议对脑活动进行长期监测可极大地改善癫痫治疗。癫痫即将发生的范式转变将涉及使用下一代慢性脑电图设备来利用已知的疾病状态生物标志物。
