Bagdorf R, Lee S I
Department of Neurology, University of Virginia Health Sciences Center, Charlottesville 22908.
Epilepsia. 1993 Mar-Apr;34(2):271-4. doi: 10.1111/j.1528-1157.1993.tb02409.x.
Clinical and electrographic features were retrospectively studied in 57 patients with midline (Fz, Cz, Pz) spikes as the only epileptiform activity in their EEG to determine possible predictors of outcome. Our study confirmed previous reports of early age of onset, activation by sleep, and Cz as the most frequent spike location. In contrast to previous studies with smaller numbers of patients, midline spikes were more common in males and most often associated with partial complex seizures and were not activated by sleep at an older age. Of the 29 patients who were followed for 6 months to 9 years, only 15 (52%) achieved good seizure control. Although a tendency toward a poor outcome was noted with several independent variables (positive family history of epilepsy, later age of seizure onset, abnormal EEG background activities, abnormal neuroimaging, abnormal neurologic examination), none was of statistical significance. This study suggests that epilepsy with midline spikes is not necessarily benign and that future studies with larger patient groups may be necessary to identify factors that influence prognosis.
对57例脑电图中仅中线（Fz、Cz、Pz）棘波作为唯一癫痫样放电活动的患者的临床和脑电图特征进行回顾性研究，以确定可能的预后预测因素。我们的研究证实了先前关于发病年龄早、睡眠激活以及Cz是最常见棘波部位的报道。与先前患者数量较少的研究不同，中线棘波在男性中更为常见，最常与部分性复杂发作相关，且在年龄较大时不会被睡眠激活。在随访6个月至9年的29例患者中，只有15例（52%）实现了良好的癫痫控制。尽管几个独立变量（癫痫家族史阳性、癫痫发作较晚的年龄、脑电图背景活动异常、神经影像学异常、神经系统检查异常）显示出预后不良的趋势，但均无统计学意义。这项研究表明，伴有中线棘波的癫痫不一定是良性的，未来可能需要对更大的患者群体进行研究，以确定影响预后的因素。
