表面蝶骨电极对于发作间期颞区异常放电的检测价值

The value of surface sphenoidal electrode in detecting interictal abnormal discharge in temporal region

目的比较表面蝶骨电极、前颞电极对癫痫患者发作间期颞区异常放电的检出率以及对不同电极记录放电波幅的比较,探讨表面蝶骨电极对于颞区异常放电的检测价值。方法连续筛选2021年10—12月在首都医科大学宣武医院门诊接受2 h视频脑电图监测的癫痫患者1356例。对全部患者安装常规头皮电极、表面蝶骨电极和前颞电极。选取表面蝶骨电极和(或)前颞电极记录到异常放电的脑电图进行分析。计算表面蝶骨电极和前颞电极对发作间期颞区放电的检出率,测量表面蝶骨电极和前颞电极记录到的放电波幅。结果最终共记录到有颞区放电的脑电图73份,共计数250个放电。其中前颞电极检出率为88.0%(220/250),表面蝶骨电极的检出率为98.4%(246/250),二者检出率差异有统计学意义(χ^(2)=18.38,P<0.001)。对于前颞区的放电(以前颞电极检出放电为“金标准”),表面蝶骨电极的检出率为98.2%(216/220),与前颞电极的检出率比较,二者之间差异无统计学意义(χ^(2)=2.27,P=0.132)。表面蝶骨电极和前颞电极同时记录到了216个放电,表面蝶骨电极记录放电的波幅为(77.1±38.9)μV,前颞电极记录放电的波幅为(80.2±44.9)μV,差异有统计学意义(t=2.28,P=0.031)。结论表面蝶骨电极对于发作间期颞区异常放电的检出率更高,可以作为脑电图的常规检查。表面蝶骨电极较前颞电极更易显示前颞以外脑区的放电。

Objective To compare the detection and amplitude of epileptiform discharges(EDs)between surface sphenoidal electrode and anterior temporal electrode in patients with interictal EDs in the temporal region,and to explore the value of surface sphenoidal electrode.Methods A total of 1356 outpatients with epilepsy who underwent 2-hour video electroencephalogram(EEG)monitoring in Xuanwu Hospital from October to December 2021 were retrospectively enrolled.All patients were hooked up with scalp electrode according to the international 10-20 system as well as surface sphenoidal electrode and anterior temporal electrode.The EEGs with EDs recorded by surface sphenoidal electrode and/or anterior temporal electrode were selected for analysis.The detection rate and the amplitude of EDs by surface sphenoidal electrode and anterior temporal electrode were compared.Results Seventy-three EEGs were collected and 250 EDs were counted.The detection rate of the anterior temporal electrode and surface sphenoidal electrode were 88.0%(220/250)and 98.4%(246/250)respectively.The difference in detection rate was statistically significant(χ^(2)=18.38,P<0.001).For the EDs from anterior temporal regions(taking the discharges recorded by anterior temporal electrode as"gold standard"),the detection rate of surface sphenoidal electrode was 98.2%(216/220).There was no statistically significant difference in detection rate between the anterior temporal electrode and surface sphenoidal electrode(χ^(2)=2.27,P=0.132).There were 216 EDs recorded by these two kinds of electrode simultaneously.The average amplitude of the EDs on surface sphenoidal electrode and anterior temporal electrode was(77.1±38.9)μV and(80.2±44.9)μV,respectively.The difference was statistically significant(t=2.28,P=0.031).Conclusions The detection rate of surface sphenoid electrodes was higher than that of anterior temporal electrodes for the EDs in the temporal region,and surface sphenoidal electrodes can be used routinely in outpatient.The surface sphenoidal electrode had more chance to detect EDs originating from regions out of the anterior temporal regions.