Hrachovy R A, Frost J D, Glaze D G
Department of Neurology, Baylor College of Medicine, Houston, Texas.
J Clin Neurophysiol. 1994 Jul;11(4):461-4.
To investigate the coupling of focal electrical seizure discharges (FS) and infantile spasms, we analyzed the video/polygraphic monitoring studies performed on 96 consecutive patients newly diagnosed with infantile spasms and hypsarrhythmic EEGs. A FS was considered to be coupled with infantile spasms if it occurred during a cluster of spasms (a series of individual spasms separated by < 1 min) or within 10 s of spasm onset or cessation. Ten patients demonstrated FS. In five patients (5% of the entire population) an apparent coupling of some FS with infantile spasms was observed during the baseline monitoring study. However, in three patients (only 3% of the entire population) was the observed coupling of FS and infantile spasms significant (p < 0.05). These results indicate that coupling of FS and infantile spasms occurs rarely, and that, in some instances, apparent couplings of FS and infantile spasms are best explained by chance coincidence. These findings do not support the hypothesis that the generation of infantile spasms at a subcortical level is dependent on a focal cortical discharge.
为研究局灶性癫痫放电（FS）与婴儿痉挛的耦合关系，我们分析了对96例新诊断为婴儿痉挛且脑电图呈高峰失律的连续患者进行的视频/多导监测研究。如果FS发生在一阵痉挛（一系列间隔<1分钟的单个痉挛）期间、痉挛发作或停止的10秒内，则认为其与婴儿痉挛耦合。10例患者出现FS。在5例患者（占总人数的5%）中，在基线监测研究期间观察到一些FS与婴儿痉挛明显耦合。然而，在3例患者中（仅占总人数的3%），观察到的FS与婴儿痉挛的耦合具有显著性（p<0.05）。这些结果表明，FS与婴儿痉挛的耦合很少发生，并且在某些情况下，FS与婴儿痉挛的明显耦合最好用偶然巧合来解释。这些发现不支持皮层下水平婴儿痉挛的产生依赖于局灶性皮层放电这一假说。
