亚临床发作在局灶性癫痫中的意义

Significance of subclinical seizures in focal epilepsy

亚临床发作(SCS)是一种发作性脑电图事件,不伴随明显的主观或客观的行为改变,在脑电监测中并不少见,其中颅内脑电图对SCS的检出率为50%~60%,明显高于头皮脑电图的检出率(约10%),且最常见于颞叶癫痫患者。在脑电特征上,SCS的发作演变常局限于致痫区,但亦可出现致痫区外的传播,其对致痫区的定位价值不亚于临床发作;此外,SCS与临床发作定位的一致性与手术预后良好相关,表明SCS对局灶性癫痫的诊疗具有重要意义。本文就国内外SCS的相关研究作系统性综述,旨在提高大家对SCS的认识。

Subclinical seizures(SCS)are paroxysmal electroencephalogram(EEG)events that do not accompany obvious subjective or objective behavioral changes.They are not uncommon in EEG monitoring,with an intracranial EEG detection rate of about 50%-60%,significantly higher than the scalp EEG detection rate of about 10%.SCS most frequently occur in patients with temporal lobe epilepsy.In terms of EEG characteristics,SCS often remain confined to the epileptogenic zone but can also spread outside of it.Their value in localizing the epileptogenic zone is comparable to that of clinical seizures(CS).Additionally,the concordance between SCS and CS localization is associated with favorable surgical outcomes,indicating the significant value of SCS in focal epilepsy.A systematic review of domestic and international research on SCS is provided in this paper,aiming to enhance understanding in this area.