Yazawa S, Ikeda A, Terada K, Mima T, Mikuni N, Kunieda T, Taki W, Kimura J, Shibasaki H
Department of Brain Pathophysiology, Kyoto University School of Medicine, Japan.
Epilepsia. 1997 Feb;38(2):245-8. doi: 10.1111/j.1528-1157.1997.tb01104.x.
A 26-year-old man with intractable focal motor seizure beginning with tonic contraction of the left orbicularis oculi muscle had prolonged EEG monitoring with subdural grid electrodes placed over the right perirolandic cortex. Electrical stimulation of the cortex with implanted subdural electrodes showed a relatively low threshold for afterdischarges (ADs) but could not disclose the motor area for the left upper face where or near where the epileptogenic area was expected to be present. Bereitschaftspotential recorded from the subdural electrodes in association with self-paced voluntary blink (eyelid closing) disclosed the motor area specifically related to voluntary movements of the left upper face, which was most likely buried in the sulcus. This observation suggests that recording of Bereitschaftspotential from subdural electrodes is useful for mapping the motor cortex, especially in patients with focal motor seizure with low threshold for ADs to electric stimuli.
一名26岁男性，患有难治性局灶性运动性癫痫，起始于左侧眼轮匝肌的强直性收缩，使用置于右侧中央前回皮质的硬膜下栅格电极进行了长时间脑电图监测。用植入的硬膜下电极对皮质进行电刺激显示，后放电（ADs）的阈值相对较低，但未能揭示左上脸的运动区，而预计致痫区就在该区域或其附近。与自主控制的随意眨眼（闭眼）相关的硬膜下电极记录的 Bereitschaft 电位揭示了与左上脸随意运动特别相关的运动区，该区域很可能深埋在沟中。这一观察结果表明，从硬膜下电极记录 Bereitschaft 电位有助于绘制运动皮质图谱，特别是对于对电刺激后放电阈值较低的局灶性运动性癫痫患者。
