Cobb W A, Guiloff R J, Cast J
Electroencephalogr Clin Neurophysiol. 1979 Sep;47(3):251-71. doi: 10.1016/0013-4694(79)90278-5.
From 33 patients with skull defects 89 EEGs were recorded, most with X ray control of the electrode sites. In 10 patients records were made shortly before and about 10 days after bone replacement. The remaining cases had EEGs either with or without bone replacement. The amplitude of alpha and frontal fast rhythms might be increased over or near unilateral posterior and frontal defects respectively. This enhancement was by a factor of less than 3. Since the electrode involved might not be in the defect but on adjacent bone this does not seem to be an effect of greater proximity to the generators. In 21 cases with defects involving or near to electrodes C3(/) and T3(4) sharply focal mu-like rhythms at 6--11 c/sec, usually with faster components, were seen. They formed two groups, at C3(4), responsive to fist clenching and other stimuli (not to eye opening) and at T3(4), unresponsive to any stimulus. In both groups the waves often had spike-like negative phases, but true spikes and also random slow waves with the same restricted focus and responsiveness were sometimes seen. Because of this complexity we prefer the term breach rhythm to mu or mu-like. Bone (or acrylic) replacement abolished central breach rhythm in 3 cases, but not in others and it might or might not restore the symmetry of alpha rhythm or fast rhythm, but burr holes, saw cuts etc., always remain after craniotomy. It is argued that, with the possible exception of 2 patients, the breach rhythms described in this series do not represent enhanced normal mu rhythm. Breach rhythm, even when very spike-like, appears to have little relationship to epilepsy and is not an indicator of recurrence of a tumour.
对33例颅骨缺损患者进行了89次脑电图记录，多数记录时对电极位置进行了X线对照。10例患者在骨置换术前及术后约10天进行了记录。其余病例的脑电图记录有的是在骨置换前，有的是在骨置换后。在单侧后颅骨和前颅骨缺损上方或附近，α波和额部快波的波幅可能会增高，增高幅度小于3倍。由于所涉及的电极可能不在缺损处而是在相邻骨上，所以这似乎不是更接近发电灶的结果。在21例电极C3（/）和T3（4）处有缺损或靠近缺损的病例中，可见到6 - 11次/秒的尖锐局灶性μ样节律，通常伴有更快的成分。它们分为两组，在C3（4）处，对握拳及其他刺激（对睁眼无反应）有反应，在T3（4）处，对任何刺激均无反应。两组中的波常有尖峰样负相，但有时也可见到真正的棘波以及具有相同局限焦点和反应性的随机慢波。由于这种复杂性，我们更倾向于用“缺口节律”一词而非“μ波”或“μ样波”。骨（或丙烯酸）置换使3例患者的中央缺口节律消失，但其他患者未消失，它可能恢复也可能未恢复α波节律或快波节律的对称性，但开颅术后骨孔、锯痕等总是会留存。有人认为，除2例患者外，本系列中描述的缺口节律并不代表正常μ波增强。缺口节律，即使非常像棘波，似乎与癫痫关系不大，也不是肿瘤复发的指标。
