Kirstein L, Nilsson B Y
EEG EMG Z Elektroenzephalogr Elektromyogr Verwandte Geb. 1977 Sep;8(3):155-61.
The effects of photic stimulation with intermittent diffuse light and patterned flash were compared in 587 patients. The diagnosis of epilepsy was unquestionable in 216 patients and suspected in 150 cases while 221 patients had no evidence of epileptic attacks. None of these patients had a history of photosensitive epilepsy. A grid pattern with squares subtending 22' of arc was used in the first 28 patients while the following 379 patients were tested with a checkerboard pattern of corresponding size. In 51 cases generalized spikes or spike-waves and/or occipital spikes were obtained. These discharges were elicited by diffuse light as well as by patterned flash in 37 patients. 11 cases were insensitive to pattern. In 3 cases spike discharges were seen only with patterned light while diffuse light was without effect. The response consisted in 13 cases of generalized spikes and spike-waves. 12 of these had an unquestionable epilepsy. Occipital spikes only were seen in 38 patients; 22 of these suffered from epilepsy. Patterned light was in no case found to be more effective than diffuse light for eliciting generalized epileptic discharges. In the 3 cases where only patterned light produced spikes, these were restricted to occipital regions. As occipital spikes do not have the same significance for the diagnosis of epilepsy as generalized spikes the addition of patterned flash to diffuse light stimulation does not seem to be of great value.
对587例患者比较了间歇性漫射光和图案化闪光的光刺激效果。216例患者癫痫诊断明确，150例疑似癫痫，221例无癫痫发作证据。这些患者均无光敏性癫痫病史。前28例患者使用了方格尺寸为22角分的网格图案，随后的379例患者用相应大小的棋盘图案进行测试。51例出现了全身性棘波或棘慢波和/或枕部棘波。37例患者的这些放电由漫射光和图案化闪光诱发。11例对图案不敏感。3例仅在图案化光刺激时出现棘波放电，漫射光无效。13例的反应为全身性棘波和棘慢波。其中12例癫痫诊断明确。仅38例患者出现枕部棘波；其中22例患有癫痫。在诱发全身性癫痫放电方面，未发现图案化光比漫射光更有效。在仅图案化光产生棘波的3例中，这些棘波仅限于枕部区域。由于枕部棘波对癫痫诊断的意义与全身性棘波不同，因此在漫射光刺激中增加图案化闪光似乎价值不大。
