Westmoreland B F
Mayo Clinic, Rochester, Minnesota 55905, USA.
Epilepsia. 1998;39 Suppl 4:S1-8. doi: 10.1111/j.1528-1157.1998.tb05121.x.
Extratemporal seizures originate from the frontal, central, parietal, occipital, and midline regions of the brain. The scalp EEG can show various types of interictal and ictal discharges consisting of spikes, spike and wave sharp waves, paroxysmal fast activity, or rhythmic activity in the beta, alpha, theta, or delta frequency ranges. The discharges can occur as focal, regional, lateralized, or secondarily generalized discharges. Discharges arising from the frontal region are varied and at times complex. Centro-temporal spikes associated with benign epilepsy of childhood have a characteristic blunt spike and wave appearance. Centro-parietal spikes can occur in children with benign childhood epilepsy or in association with symptomatic epilepsies at any age. Occipital spike discharges have been seen in young children with visual problems, benign occipital epilepsy of childhood, the Sturge-Weber syndrome, and other symptomatic or structural lesions involving the occipital lobe. There may be problems with detection of the source of origin of seizures secondary to the anatomy of the various regions, deep foci, small restricted foci, rapid spread of epileptiform discharges, and contaminating effects of muscle and movement artifact. Depth or intracranial recordings may help in further localization of foci.
颞叶外癫痫发作起源于大脑的额叶、中央区、顶叶、枕叶和中线区域。头皮脑电图可显示各种类型的发作间期和发作期放电,包括棘波、棘慢波、阵发性快活动或β、α、θ或δ频率范围内的节律性活动。放电可表现为局灶性、区域性、单侧性或继发性全身性放电。额叶区域产生的放电多样,有时较为复杂。与儿童良性癫痫相关的中央颞区棘波具有特征性的钝棘慢波形态。中央顶叶棘波可出现在儿童良性癫痫患者中,或在任何年龄与症状性癫痫相关。枕叶棘波放电可见于有视觉问题的幼儿、儿童良性枕叶癫痫、斯特奇-韦伯综合征以及其他累及枕叶的症状性或结构性病变。由于各区域的解剖结构、深部病灶、小局限性病灶、癫痫样放电的快速传播以及肌肉和运动伪迹的干扰作用,癫痫发作起源部位的检测可能存在问题。深部或颅内记录可能有助于进一步定位病灶。