Pacia S V, Jung W J, Devinsky O
Department of Neurology, New York University School of Medicine, Hospital for Joint Diseases, New York 10003, USA.
J Clin Neurophysiol. 1998 May;15(3):256-61. doi: 10.1097/00004691-199805000-00010.
Few studies have compared sphenoidal electrodes with scalp electrodes to determine their localizing value in temporal lobe seizures. We reviewed 76 ictal recordings with the standard International 10-20 System and T1/2 and sphenoidal electrodes from 31 patients whose subsequent intracranial EEG studies precisely localized seizures in one temporal lobe. Ictal EEGs were reviewed in a blinded fashion in both longitudinal bipolar and referential montages. Of the 23 seizures in 11 patients with mesial temporal lobe epilepsy (MTLE), all seven seizures in 3 patients were localized exclusively to one sphenoidal electrode, before involvement of T1/2 and temporal scalp electrodes. The remaining 16 seizures from 8 MTLE patients and all 53 seizures in the 20 patients with neocortical temporal lobe epilepsy (NTLE) had simultaneous involvement of sphenoidal, T1/2, and temporal scalp electrodes at seizure onset when analyzed with referential montages. Sphenoidal electrodes may provide valuable localization data for presurgical evaluation of patients with possible TLE. In particular, seizure rhythms confined to the sphenoidal electrode at ictal onset, without involvement of scalp electrodes, occurred only in patients with MTLE (p < 0.04). Further studies comparing these electrodes with other types of surface electrodes are needed.
很少有研究比较蝶骨电极和头皮电极在颞叶癫痫中的定位价值。我们回顾了31例患者的76次发作期记录，这些记录采用标准的国际10 - 20系统以及T1/2和蝶骨电极，随后的颅内脑电图研究精确地将癫痫发作定位于一个颞叶。以盲法对发作期脑电图进行纵向双极和参考导联组合的回顾。在11例内侧颞叶癫痫（MTLE）患者的23次发作中，3例患者的所有7次发作在T1/2和颞部头皮电极受累之前仅定位于一个蝶骨电极。当用参考导联组合分析时，8例MTLE患者的其余16次发作以及20例新皮质颞叶癫痫（NTLE）患者的所有53次发作在发作开始时蝶骨、T1/2和颞部头皮电极同时受累。蝶骨电极可为可能患有颞叶癫痫（TLE）的患者术前评估提供有价值的定位数据。特别是，发作开始时局限于蝶骨电极且不累及头皮电极的发作节律仅出现在MTLE患者中（p < 0.04）。需要进一步研究将这些电极与其他类型的表面电极进行比较。
