Steinhoff B J, So N K, Lim S, Lüders H O
Department of Neurology, Cleveland Clinic Foundation, OH, USA.
Neurology. 1995 May;45(5):889-96. doi: 10.1212/wnl.45.5.889.
We investigated the ictal scalp EEG in 228 seizures of 36 patients with unitemporal (n = 25) or bitemporal independent (n = 11) interictal epileptiform discharges (IED). All patients had proven temporal lobe epilepsy since they became seizure-free or only had auras after temporal lobectomy with a minimum follow-up of 1 year. Ictal patterns at seizure onset or later in the course of the seizure were lateralized significantly more often in patients with unitemporal IED (90%, at seizure onset and 96%, later) compared with those with bitemporal independent IED (75%, at seizure onset and 78%, later). Furthermore, scalp ictal EEGs, when lateralized at seizure onset or later in the course of the seizure, were significantly more likely to predict the correct side for surgery in patients with unitemporal (98%, at seizure onset and 100%, later) than bitemporal (64%, at seizure onset and 77%, later) IED. Bilateral independent seizure onsets, asynchrony of ictal activity over the two temporal lobes, and switch of ictal activity from one to the other hemisphere are ictal patterns that are strongly correlated with bitemporal excitability.
我们对36例有单侧颞叶（n = 25）或双侧颞叶独立发作间期癫痫样放电（IED）的患者的228次发作的发作期头皮脑电图进行了研究。所有患者均经证实患有颞叶癫痫，因为他们在颞叶切除术后无发作或仅出现先兆，且至少随访1年。与双侧颞叶独立IED患者相比，单侧颞叶IED患者在发作开始时或发作过程后期的发作模式明显更常出现侧化（发作开始时为90%，后期为96%）（发作开始时为75%，后期为78%）。此外，头皮发作期脑电图在发作开始时或发作过程后期出现侧化时，单侧颞叶IED患者（发作开始时为98%，后期为100%）比双侧颞叶IED患者（发作开始时为64%，后期为77%）更有可能准确预测手术侧。双侧独立发作起始、双侧颞叶发作期活动不同步以及发作期活动从一个半球切换到另一个半球是与双侧颞叶兴奋性密切相关的发作模式。
