Grunwald T, Elger C E, Lehnertz K, Van Roost D, Heinze H J
University Clinic of Epileptology, Bonn, Germany.
Electroencephalogr Clin Neurophysiol. 1995 Jul;95(1):53-62. doi: 10.1016/0013-4694(95)00015-q.
During presurgical evaluation event-related potentials were recorded with depth electrodes located longitudinally within the hippocampus in 25 patients suffering from unilateral temporal lobe epilepsy. Rare stimuli in a visual oddball paradigm elicited a pronounced negativity ("NO") in the hippocampal body. Amplitudes were significantly reduced on the side of the primary epileptogenic area. Visual presentations of words in a recognition paradigm evoked an earlier negativity ("ENW") in anterior and a later negativity ("LNW") in posterior hippocampal structures. Both were sensitive for recognition effects and showed reduced amplitudes on the side of the primary epileptogenic area. Relating the differences of left and right hippocampal "NO" and "ENW" amplitudes proved to be a sensitive method for topological diagnosis and allowed a correct lateralization of the primary epileptogenic area in all patients. Amplitudes of the hippocampal ENW, evoked in the dominant hemisphere by first presentations, strongly correlated with the recognition rate, when the primary epileptogenic area was situated in the contralateral temporal lobe. This correlation was reduced by the presence of ipsilateral epileptogenic foci.
在术前评估期间，对25例单侧颞叶癫痫患者使用纵向置于海马体内的深度电极记录事件相关电位。视觉oddball范式中的罕见刺激在海马体中引发明显的负电位（“NO”）。在原发性致痫区一侧，其波幅显著降低。识别范式中单词的视觉呈现在前海马结构中诱发较早的负电位（“ENW”），在后海马结构中诱发较晚的负电位（“LNW”）。两者对识别效应均敏感，且在原发性致痫区一侧波幅降低。比较左右海马“NO”和“ENW”波幅差异被证明是一种敏感的拓扑诊断方法，能在所有患者中正确定位原发性致痫区。当原发性致痫区位于对侧颞叶时，优势半球首次呈现诱发的海马ENW波幅与识别率密切相关。同侧致痫灶的存在会降低这种相关性。
