BACKGROUND： Low-frequency repetitive transcranial magnetic stimulation （rTMS） has been shown to significantly reduce epileptiform discharges and control clinical seizures in intractable epilepsy patients. The locat...BACKGROUND： Low-frequency repetitive transcranial magnetic stimulation （rTMS） has been shown to significantly reduce epileptiform discharges and control clinical seizures in intractable epilepsy patients. The location of epileptic foci and magnetic stimulation sites remain uncertain. The effects of rTMS on electroencephalogram and seizure remain unclear in epileptic patients following dipole source localization. OBJECTIVE： To investigate the effects of low-frequency rTMS on electroencephalogram and seizure in temporal lobe epilepsy patients after dipole source localization. DESIGN, TIME AND SETTING： The randomized, controlled study was performed at the outpatient clinic Department of Neurology, Hospital Affiliated to North Sichuan Medical College from December 2003 to February 2007. PARTICIPANTS： A total of 30 temporal lobe epilepsy patients, comprising 19 males and 11 females, aged 1749 years, presented with epileptiform discharges and were enrolled for this study. Disease course ranged between 1-6 years, with 1-5 seizures per month. Imaging examinations revealed 11 patients with structural changes in the brain. The patients were randomly and equally assigned into drug treatment and transcranial magnetic stimulation （TMS） groups. METHODS： Patients in the drug treatment group were orally treated with carbamazepine. Patients in the TMS group received oral carbamazepine treatment of and TMS. A Maglite-r25 magnetic stimulator （Dantec Dynamics, Denmark） was used to stimulate epileptic foci in the temporal lobe following electroencephalogram dipole localization （1 Hz, 90% threshold intensity, at a stimulation frequency of 500 times, once a day, for 7 days）. MAIN OUTCOME MEASURES： At 30 days after TMS, seizure frequency and rate of epileptiform discharges were observed in patients from both groups. Therapeutic safety was investigated during treatment. RESULTS： Within 30 days of treatment, there were no significant differences in seizure frequency between the TMS group （1.5 ± 0.3） seizures and the drug treatment group [（1.9± 0.4） seizures] （P 〉 0.05）. The rate of epileptiform discharges [27% （4/15）] was significantly less in the TMS group than in the drug treatment group [73% （11/15）] （P 〈 0.05）. During TMS, five patients suffered from transient mild headache, but were completely relieved within 2 hours. CONCLUSION： Low-frequency rTMS exhibited inhibitory effects on epileptiform discharges over a short period of time, and decreased seizure frequency to some degree. Results from the present study suggested that low-frequency rTMS is safe.展开更多
This review hopes to clearly explain the following viewpoints： （1） Neuronal synchronization underlies brain functioning, and it seems possible that blocking excessive synchronization in an epileptic neural network ...This review hopes to clearly explain the following viewpoints： （1） Neuronal synchronization underlies brain functioning, and it seems possible that blocking excessive synchronization in an epileptic neural network could reduce or even control seizures. （2） Local field potential coupling is a very common phenomenon during synchronization in networks. Removal of neurons or neuronal networks that are coupled can significantly alter the extracellular field potential. Interventions of coupling mediated by local field potentials could result in desynchronization of epileptic seizures. （3） The synchronized electrical activity generated by neurons is sensitive to changes in the size of the extracellular space, which affects the efficiency of field potential transmission and the threshold of cell excitability. （4） Manipulations of the field potential fluctuations could help block synchronization at seizure onset.展开更多
Sleep and waking EEG of 522 patients with epilepsy and various disease with attack nature were studied. EEG showed paroxysmal activities(PA) in 217 cases. PA appeared only during sleep in 96 cases. Posi- tive rate of ...Sleep and waking EEG of 522 patients with epilepsy and various disease with attack nature were studied. EEG showed paroxysmal activities(PA) in 217 cases. PA appeared only during sleep in 96 cases. Posi- tive rate of EEG diagnosis increased from 23. 2 percent in waking recordings to 41. 6 percent. Fifty of 97 benign childhood epilepsy with centrotemporal spike(51. 6% ) had focal PA only during sleep. Two of 6 cases with Lennox-Gastaut syndrome showed tonic seizure and/or generalized paroxysmal fast activities, Seizure types of 15 patients were defined by interictal PA and letal EEG during sleep. There was no corre- sponding relationship between seizure time(waking or sleep) and PA sensitivity to state of vigilance.展开更多
Objective To review the recent development of functional MRI application in epilepsy. Data sources Both Chinese and English language literatures were researched using MEDLINE/ CD ROM (1996-2005) and the Chinese Biom...Objective To review the recent development of functional MRI application in epilepsy. Data sources Both Chinese and English language literatures were researched using MEDLINE/ CD ROM (1996-2005) and the Chinese Biomedical Literature Disk (1996-2005). Study selection Published articles about functional MRI application and epilepsy were selected.Data extraction Data were mainly extracted from 38 articles which are listed in the reference section of this review.Results fMRI can be used to localize seizure foci through detecting these cerebral hemodynamic changes produced by epileptiform discharges. EEG-triggered fMRI, which has higher spatial and temporal resolution, helps to detect the spatiotemporal pattern of spike origin and propagation, and define localization of the epileptogenic focus. fMRI is also useful in language and memory cognitive function assessment and presurgical assessment of refractory epilepsy. Atypically distributed cognitive function areas can be detected by fMRI, because of cortical language and memory areas reorganization during long-term epileptic activity in patients with epilepsy. Conclusions fMRI technique plays a very important role in cognitive function and presurgical assessment of patients with epilepsy. It is meaningful for understanding pathogenesis of epilepsy.展开更多
目的分析伴随各种发作性症状的脑性瘫痪(CP)患儿视频脑电图(VEEG)特征,鉴别癫与非癫事件。方法伴各种发作性症状的522例CP患儿分为临床确诊癫组(A组,215例)及可疑癫组(B组,307例)。分别对其进行24 h VEEG监测。结果A组检出样放...目的分析伴随各种发作性症状的脑性瘫痪(CP)患儿视频脑电图(VEEG)特征,鉴别癫与非癫事件。方法伴各种发作性症状的522例CP患儿分为临床确诊癫组(A组,215例)及可疑癫组(B组,307例)。分别对其进行24 h VEEG监测。结果A组检出样放电183例(85.12%),监测到临床发作127例(59.07%)并明确了发作类型;B组检出样放电58例(18.90%),监测到临床发作264例(86.0%),其中210例(40.23%)同步VEEG无样放电而排除癫发作;292例VEEG非特异性异常(55.94%),二组无显著差异(P>0.05)。结论CP患儿VEEG非特异性异常及样放电率较高,但相当部分伴随的发作性症状为非癫事件。展开更多
基金the Youth Foundation Program of Sichuan Province,No.04ZQ026-010
文摘BACKGROUND： Low-frequency repetitive transcranial magnetic stimulation （rTMS） has been shown to significantly reduce epileptiform discharges and control clinical seizures in intractable epilepsy patients. The location of epileptic foci and magnetic stimulation sites remain uncertain. The effects of rTMS on electroencephalogram and seizure remain unclear in epileptic patients following dipole source localization. OBJECTIVE： To investigate the effects of low-frequency rTMS on electroencephalogram and seizure in temporal lobe epilepsy patients after dipole source localization. DESIGN, TIME AND SETTING： The randomized, controlled study was performed at the outpatient clinic Department of Neurology, Hospital Affiliated to North Sichuan Medical College from December 2003 to February 2007. PARTICIPANTS： A total of 30 temporal lobe epilepsy patients, comprising 19 males and 11 females, aged 1749 years, presented with epileptiform discharges and were enrolled for this study. Disease course ranged between 1-6 years, with 1-5 seizures per month. Imaging examinations revealed 11 patients with structural changes in the brain. The patients were randomly and equally assigned into drug treatment and transcranial magnetic stimulation （TMS） groups. METHODS： Patients in the drug treatment group were orally treated with carbamazepine. Patients in the TMS group received oral carbamazepine treatment of and TMS. A Maglite-r25 magnetic stimulator （Dantec Dynamics, Denmark） was used to stimulate epileptic foci in the temporal lobe following electroencephalogram dipole localization （1 Hz, 90% threshold intensity, at a stimulation frequency of 500 times, once a day, for 7 days）. MAIN OUTCOME MEASURES： At 30 days after TMS, seizure frequency and rate of epileptiform discharges were observed in patients from both groups. Therapeutic safety was investigated during treatment. RESULTS： Within 30 days of treatment, there were no significant differences in seizure frequency between the TMS group （1.5 ± 0.3） seizures and the drug treatment group [（1.9± 0.4） seizures] （P 〉 0.05）. The rate of epileptiform discharges [27% （4/15）] was significantly less in the TMS group than in the drug treatment group [73% （11/15）] （P 〈 0.05）. During TMS, five patients suffered from transient mild headache, but were completely relieved within 2 hours. CONCLUSION： Low-frequency rTMS exhibited inhibitory effects on epileptiform discharges over a short period of time, and decreased seizure frequency to some degree. Results from the present study suggested that low-frequency rTMS is safe.
基金supported by grants from the National Natural Science Foundation of China,No. 30971534125 Project of the Third Xiangya Hospital of Central South University,China
文摘This review hopes to clearly explain the following viewpoints： （1） Neuronal synchronization underlies brain functioning, and it seems possible that blocking excessive synchronization in an epileptic neural network could reduce or even control seizures. （2） Local field potential coupling is a very common phenomenon during synchronization in networks. Removal of neurons or neuronal networks that are coupled can significantly alter the extracellular field potential. Interventions of coupling mediated by local field potentials could result in desynchronization of epileptic seizures. （3） The synchronized electrical activity generated by neurons is sensitive to changes in the size of the extracellular space, which affects the efficiency of field potential transmission and the threshold of cell excitability. （4） Manipulations of the field potential fluctuations could help block synchronization at seizure onset.
文摘Sleep and waking EEG of 522 patients with epilepsy and various disease with attack nature were studied. EEG showed paroxysmal activities(PA) in 217 cases. PA appeared only during sleep in 96 cases. Posi- tive rate of EEG diagnosis increased from 23. 2 percent in waking recordings to 41. 6 percent. Fifty of 97 benign childhood epilepsy with centrotemporal spike(51. 6% ) had focal PA only during sleep. Two of 6 cases with Lennox-Gastaut syndrome showed tonic seizure and/or generalized paroxysmal fast activities, Seizure types of 15 patients were defined by interictal PA and letal EEG during sleep. There was no corre- sponding relationship between seizure time(waking or sleep) and PA sensitivity to state of vigilance.
文摘Objective To review the recent development of functional MRI application in epilepsy. Data sources Both Chinese and English language literatures were researched using MEDLINE/ CD ROM (1996-2005) and the Chinese Biomedical Literature Disk (1996-2005). Study selection Published articles about functional MRI application and epilepsy were selected.Data extraction Data were mainly extracted from 38 articles which are listed in the reference section of this review.Results fMRI can be used to localize seizure foci through detecting these cerebral hemodynamic changes produced by epileptiform discharges. EEG-triggered fMRI, which has higher spatial and temporal resolution, helps to detect the spatiotemporal pattern of spike origin and propagation, and define localization of the epileptogenic focus. fMRI is also useful in language and memory cognitive function assessment and presurgical assessment of refractory epilepsy. Atypically distributed cognitive function areas can be detected by fMRI, because of cortical language and memory areas reorganization during long-term epileptic activity in patients with epilepsy. Conclusions fMRI technique plays a very important role in cognitive function and presurgical assessment of patients with epilepsy. It is meaningful for understanding pathogenesis of epilepsy.
文摘目的分析伴随各种发作性症状的脑性瘫痪(CP)患儿视频脑电图(VEEG)特征,鉴别癫与非癫事件。方法伴各种发作性症状的522例CP患儿分为临床确诊癫组(A组,215例)及可疑癫组(B组,307例)。分别对其进行24 h VEEG监测。结果A组检出样放电183例(85.12%),监测到临床发作127例(59.07%)并明确了发作类型;B组检出样放电58例(18.90%),监测到临床发作264例(86.0%),其中210例(40.23%)同步VEEG无样放电而排除癫发作;292例VEEG非特异性异常(55.94%),二组无显著差异(P>0.05)。结论CP患儿VEEG非特异性异常及样放电率较高,但相当部分伴随的发作性症状为非癫事件。
