颞叶癫癎的头皮和深部电极脑电发作期特点

Characteristics of ictal temporal lobe epileptiform discharge on scalp or depth electrodes electroencephalograms

目的：探讨手术治愈和基本治愈的颞叶癫癎（TLE）患者发作期头皮脑电图（EEG）和深部电极EEG的特点.方法：对25例立体定向射频热凝毁损颞叶内侧结构或常规手术切除后随访12月以上,Engel Ⅰ级（临床治愈）者21例和EngelⅡ级（临床基本治愈）者4例（共25例）的发作期头皮EEG和深部电极发作期特点进行分析.结果：头皮EEG描记时逢临床发作者19例,其中EEG为局限的5～13 Hz的典型阵发性节律波者10例,14～20 Hz的快波者4例,局限的2～5 Hz的正弦节律波者3例,EEG呈平坦化2例;深部EEG描记已临床发作者6例,均有15～6 Hz的节律波发放.结论：对于TLE头皮EEG对大多数发作能提供发作起始参考,对于EEG平坦化者需参考其它临床资料;深部电极EEG发作期脑电起始形式比较单一.

Objective：To investigate the characteristics of ictal temporal lobe epileptiform discharge on scalp or depth electrode electroencephalograms（EEGs）. Methods..Twenty-five patients with temporal lobe epilepsy（TLE） were treated by stereotactic mesial temporal lobe radiofrequency thermocoagulation or routine operation（selective amygdalohippocampectomy, tumor resection or anterior temproal lbectomy） with more than 12 months follow-ups. Of 21 patients with Engel＇s Class I （cured）and 4 patients with Engel＇s Class II （mostly cured）,the characteristics of ictal epileptiform discharge on scalp or depth electrode EEGs was analysed. Results：In scalp EEGs,of 19 cases clinical seizures there were rhythmic ictal epileptiform waves in 5 to 13 Hz in 10 cases,with rhythmic ictal β waves in 14 to 20 Hz in 4 cases,sinu- soidal ictal epileptiform waves in 2 to 5 Hz in 3 cases and with background attenuation in 2 cases. In depth electrode EEGs of 6 cases with clinical seizures, all of them showed regular rhythmic ictal waves with 6 to 15 Hz. Conclusion： To the TLE,the ictal characteristics of scalp EEGs can locate the epileptic onset zone for most kinds of epileptic seizures, but for the electrode cremental events, more additional evidences were needed. Wave form of ictal depth EEGs was single.