头皮脑电发作间期痫样放电侧别与海马硬化侧别的一致性研究  

Study on the consistency between epilepsy discharge side and hippocampal sclerosis side in scalp EEG

作　　者：马慧娟 林华[2] 叶静[2] 崔洁 徐建民 Ma Huijuan;Lin Hua;Ye Jing;Cui Jie;Xu Jianmin(Epilepsy of Center,the Beijing Fengtai Youanmen Hospital,Beijing 100071,China)

机构地区：[1]丰台右安门医院,北京100071 [2]首都医科大学宣武医院

出　　处：《脑与神经疾病杂志》2020年第3期133-136,共4页Journal of Brain and Nervous Diseases

基　　金：国家自然科学基金面上项目（81771398）

摘　　要：目的探讨伴有海马硬化的癫痫患者头皮脑电发作间期痫样放电侧别与海马硬化侧别的一致性。方法将289例癫痫患者分为左侧海马硬化组、右侧海马硬化组和双侧海马硬化组,(1)观察痫样放电与海马硬化侧别关系;(2)左侧海马硬化组和右侧海马硬化组的同侧放电、对侧或双侧痫样放电构成比。结果右侧海马硬化患者的双侧放电25例(38.4%)以及左侧或双侧放电(两者均累及了主侧半球)32例(49.2%)比左侧海马硬化患者的双侧放电15例(28.8%)以及右侧或双侧(两者均累及非主侧半球)19例(36.5%)明显增多,(P<0.01);双侧海马硬化组中左侧放电26例(15.1%)比右侧放电17例(9.9%)明显增多,(P<0.05)。结论 (1)非主侧半球痫样放电更容易传播到主侧半球导致双侧放电,主侧半球痫样放电率更高;(2)痫样放电侧别和海马硬化侧别一致性不高,这说明单靠头皮脑电痫样放电侧别和海马硬化侧别来对致痫灶定侧有很大局限性。objective to investigate the consistency between epilepsy discharge side and hippocampal sclerosis side by scalp electroencephalogram(E E G) in epilepsy patients with hippocampal sclerosis. Methods 289 epilepsy patients with hippocampal sclerosis were divided into left hippocampal sclerosis group, right hippocampal sclerosis group and bilateral hippocampal sclerosis group.(1) To observe the relationship between epileptic discharge and hippocampal sclerosis in every group;(2) The composition ratio of ipsilateral discharge, contralateral or bilateral epileptic discharge was compared between left hippocampal sclerosis group and right hippocampal sclerosis group. Results In the patients with right hippocampal sclerosis, the bilateral discharge in 25 patients(38.4%) and contralateral or bilateral discharge in 32 patients(49.2%) were significantly more than that in the patients with left hippocampal sclerosis in 15 patients(28.8%) of the bilateral discharge and contralateral or bilateral discharge in 19 patients(36.5%)(P<0.01). In the bilateral hippocampal sclerosis group, 26 cases(15.1%) discharged from the left side were more than 17 cases(9.9%) discharged from the right side, with a significant difference(P<0.05). Conclusion(1) Non-main hemisphere epileptic discharge is more likely to spread to the main hemisphere leading to bilateral discharge, and the epileptic discharge rate is higher in the main hemisphere;(2) The consistency of epileptic discharge and hippocampal sclerosis was not high. These results suggest that there are great limitations in the determination of Lateral features of seizure onset zone by epilepy discharge and hippocampal sclerosis alone.

关 键 词：海马硬化 癫痫 发作间期 头皮脑电 痫样放电 主侧半球 

分 类 号：R742.1[医药卫生—神经病学与精神病学]