18例复杂部分性癫痫发作患者同步录像脑电图监测报告

目的：探讨同步录像脑电图（Video-EEG）在复杂部分性癫痫发作诊断中的应用价值。方法：利用ZN8000型EEG仪对临床确诊的18例复杂部分性发作患者进行脑电和行为监测,监测时间2．5～28h平均用18.8h。结果：共监测到93次临床发作,睡眠中发作54次,清醒时发作39次,发作持续时间7～120s,平均34．8s。发作时的临床表现：双眼向前或向一侧凝视11例,头向一侧转动9例,一侧面部或肢体抽搐9例,行为或口咽自动症6例,精神症状5例,姿势性发作5例,对发作过程不能回忆15例。发作期EEG示癫病样放电（棘波、尖波、棘慢、尖慢综合波）12例,阵发性高幅慢波5例,未见异常1例,EEG异常率95％。发作间期EEG示中高幅阵发性慢波3例,阵发性痫样放电9例,未见异常6例,EEG异常率65％。结论：Video－EEG对复杂部分性癫痫发作有重要诊断价值,痫样放电与临床发作密切相关。     

伴中央颞区棘波儿童良性癫癎脑电图分析

目的：分析伴中央颞区棘波儿童良性癫癎(BECT)患儿的脑电图表现。方法：对52例临床明确诊断的BECT患儿进行脑电图描记。结果：52例患者中,癫癎样波形出现在清醒描记时39例,出现在NREMⅠ—Ⅱ期13例。其中仅出现棘波者31例,尖波者16例,棘、尖波均出现者5例。癫癎样波形仅出现在中央和(或)颞区者43例,除见于中央、颞区外亦散在性出现于其他脑区者9例,其中双额区明显者1例,一侧枕区明显者1例。有2例在清醒描记时出现典型中央颞区棘波,过度换气时出现广泛性双侧同步性3～4 Hz棘慢波综合。结论：大多数BECT患儿有典型的特征性脑电图表现,但少数患儿可出现其它脑电图异常,应注意鉴别。     

Spike voltage topography and equivalent dipole localization in complex partial epilepsy

Summary The EEG of 45 patients with complex partial epilepsy was recorded from standard and supplementary inferior temporal electrode sites for 2 or more days via cable telemetry onto video (VHS) tape (22–25 channels, common reference). Epochs with "temporal spikes" were read into a topographic EEG device where individual spikes were visually identified and averaged in sums of 8–32. Analysis of spike voltage topography revealed two distinct patterns - dipolar, Type 1 and non-dipolar, Type 2. One or the other spike type predominated in all but two patients. Application of source modeling techniques (3 shells, single dipole, 6 parameters) to the spike topography data revealed that both spike types had similar equivalent dipoles in terms of location and orientation, except for vector elevation. However, calculated dipoles for Type 1 spikes were more stable over the course of the spike peak. Correlations with clinical data and intracranial EEG suggest that Type 1 spikes originate in mesial temporal structures, while Type 2 spikes arise from temporal or frontal neocortex. Spike voltage topography and equivalent dipole localization appear to be useful in the presurgical evaluation of patients with focal epilepsy.Acknowledgements: We appreciate the co-operation of our colleagues, Peter Williamson, Susan Spencer, and Richard Mattson and the assistance of their fellows, Vijay Thidani, Amiram Katz, David Marks, and Richard Scheyer.     

39例复杂部分性发作癫灶的PET与EEG定位诊断比较

目的 :探讨临床表现不同的癫复杂部分性发作 (CPS)与正电子发射断层扫描 (PET)检查病灶定位的相关性。方法 :39例CPS病人经PET、磁共振成像 (MRI)、录像 脑电监测 (Video EEG)检查 ,并对各种检查和临床表现进行比较分析。结果 :PET和EEG二者完全符合和部分符合均为 31% ,15例不符病例中 ,12例为PET有定位价值而EEG不能定位。仅表现为复杂部分性发作而无继发性全身性强直阵挛发作 (GS)者的 71%的病例 ,PET定位于单侧颞叶 ,表现为CPS继发GS者的 81%为颞顶、颞枕区病灶。结论 :CPS不继发全身性发作的患者 ,病灶多局限于一侧颞叶 ,如发作期和发作间期脑电图均正常 ,更应考虑病灶位于颞叶内侧面 ,或边缘系统 ;CPS继发GS的患者病灶多位于颞叶外侧面与顶、枕交界区。     

Intracerebral dipole sources of EEG FFT power maps

Summary The described method opens a way to compute intracerebral source localizations of ongoing EEG activity. A sine-cosine diagram of the Fourier-transformed data is constructed for each frequency point, forming a "FFT constellation" of entries. Into the FFT constellation of each diagram, a straight line is fitted which produces the least squared deviation sum between the original entry positions and their orthogonal projections onto that line. The map landscape described by the voltages between the projected positions ("FFT approximation") is the least error compromise landscape of all possible landscapes during the paradigmatic cycle of the given FFT frequency. The map thus constructed can be used in the usual dipole source localization procedures. There is one for each FFT frequency point. The squared forward solution of the fitted dipole source and the squared FFT approximation map are "power maps" which are very similar to the original power map. For an average-reference power map with two peaks, the source tends to lie between the peaks; a power map with one peak might show closely neighboring maximal and minimal potential values in the FFT approximation, indicative of a tangential source close to the surface.Acknowledgement: The authors thank D. Brandeis and W. Karniski for helpful discussions. Support from the EMDO Foundation, the Hartmann-Muller-Foundation and the Sandoz-Foundation for Medical-Biological Research is gratefully acknowledged.     

22例继发性癫痫皮层电图与脑电图的关系

对我院１９９２～１９９４年２２名继发性癫痫患者的皮层电图（ＥＣｏＧ）与普通脑电图（ＥＥＧ）的关系，结合ＣＴ及病理所见作了对比。本组３种类型癫痫患者的皮层痫灶主要集中在额中、颞中、前颞，三者占总数的８５％。ＥＣｏＧ上相邻３个电极出现棘波发作者，在ＥＥＧ上可出现相应的棘、尖波灶，反之则不然。ＥＥＧ多形性δ波灶提示患者脑器质性病变，应进一步作影象检查。ＥＣｏＧ可在病灶周围找到皮层棘波灶。     

动态脑电图对癫痫诊断和鉴别诊断的意义

对临床诊断癫痫的５３例和可疑癫痫的１１７例行２４ｈ动态脑电图（ＡＥＥＧ）监测。结果ＡＥＥＧ阳性率（３２．９％）明显高于常规ＥＥＧ（２０％），ＡＥＥＧ痫样放电率在癫痫组为５４．７％（２９／５３），可疑癫痫组为１５．４％（１８／１１７）。后者中有临床发作者６３例，检出痫样放电１０例，睡眠期出现痫样放电占８９．４％（４２／４７）。本文对痫样放电出现与临床发作间的关系以及癫痫诊断和鉴别诊断进行了讨论。     

BECT患儿录像脑电图表现和临床治疗的回顾性分析

目的：总结伴有中央颞区棘波的小儿良性癫痫（BECT）录像脑电图（视频脑电图,VEEG）和临床治疗的结果。方法：对139例BECT患儿的脑电图（EEG）表现和临床治疗进行回顾性分析。结果：本组发病年龄：2～12岁134例,占总数的96％,13～14岁5例,占总数的4％。只在睡眠中发作122例,清醒和睡眠均发作者15例,仅在白天觉醒时发作者2例。复杂部分性发作（CPS）34例,单纯部分性发作（SPS）34例,继发全身性发作（SGS）42例,全身强直阵挛发作（GTCS）1例,或兼有以上两种或两种以上发作类型合计22例,无法分类6例。剥夺睡眠后V-EEG描记发现：发作间期均有一侧或双侧中央颞区棘（尖）波。经过正规抗癫痫药物治疗2～5年后有69例临床完全不发作。结论：BECT临床发作和睡眠密切相关。发作间期EEG均有一侧或双侧中央和中颞区棘（尖）波。睡眠期EEG阳性率显著高于清醒期EEG。抗癫痫药物治疗反应良好,预后良好。     

The EEG mapping in the evaluation of patients with late onset epilepsy

In 62 patients with late onset epilepsy the findings of EEG mapping routine EEG and CT were compared. Forty four patients had generalized, 18 partial seizures. In 39 patients (63%) EEG mapping revealed focal changes but only in 24 patients (39%) using routine EEG alone. Thus the EEG mapping showed focal abnormalities significantly more often and this could be demonstrated in the separated groups of patients with generalized or partial seizures as well. Lesions in CT occurred in 39 patients (63%). The focal abnormalities in EEG mapping were significantly related to the lesions in CT. Moreover focal changes corresponding to CT lesions were obtained by means of EEG mapping in 32 patients (82%) but only in 20 patients (51%) using routine EEG and in that way the EEG mapping could indicate focal lesions in CT significantly more often than routine EEG. Regarding etiology this was especially seen in the group with vascular origin of epilepsy.     

颞叶癫痫病人睡眠EEG放电规律的探讨

目的：探讨颞叶癫痫患者昼与夜的脑电图痫样放电特点。方法：对２０例颞叶癫痫患者及同年龄、性别的对照组进行连续４８ｈＥＥＧ监测，就其临床发作频率、睡眠各期痫样放电的频率、时程进行分析。结果：ＥＥＧ监测期间共发生１３次临床发作。其中清醒时６次，睡眠中７次；２０例病人均检出痫样放电，１８例出现于清醒和睡眠时，１例仅出现于睡眠中，另一例仅出现于清醒时。痫样放电出现于非眼快动睡眠相（ＮＲＥＭ）１期１６例，２期１８例，３期３例，４期４例，出现于眼快动睡眠相（ＲＥＭ）１２例。结论：颞叶癫痫的临床发作频率和痫样放电频率在清醒和睡眠时期基本相等。痫样放电在ＮＲＥＭ的１、２期和ＲＥＭ期明显增加     

EEG mapping for surgery of epilepsy

Summary This report describes the objectives, problems, and current techniques associated with using EEG maps in the management of surgery of epilepsy. The purpose of EEG mapping in epilepsy is to precisely identify and characterize epileptogenic zones of the brain. Such zones may be single or multiple, pointlike or diffuse, and may be near or distant from the recording electrodes. The resulting measured electric fields are used to obtain information which, when analyzed in light of all the complementary clinical information, can frequently help to localize and describe the epileptic foci with more precision.     

75例颞叶癫癎患者动态EEG与过度换气EEG癎样放电规律探讨

目的：了解睡眠EEG与过度换气EEG的痢样放电规律。方法：评估75例颞叶癫痫患者动态EEG与过度换气EEG的痫样放电特点。结果：过度换气EEG痫样放电检出率明显低于浅睡期EEG，差异具有极显著意义（P〈0．01）；但与清醒期和深睡期EEG痫样放电检出率比较差异无显著意义（P〉0．05）。结论：颞叶癫痫患者浅睡期EEG痫样放电率明显高于过度换气EEG，对颞叶癫痫患者进行睡眠EEG检测，有助于提高痫样放电的检出率。     

难治性癫痫患者的EEG特点与病因探讨

目的 :探讨难治性癫的脑电图 (EEG)特点与病因。方法 :对 78例难治性癫患者的常规EEG和头颅磁共振成像 (MRI)检查资料进行分析。结果 :EEG上波检出率仅为 2 8% ,慢波异常率则高达 6 8%。其中不同发病年龄组 (<14岁和≥ 15岁 )和不同病程组 (<10年和≥ 10年 )的样波检出率和慢波异常率比较 ,差异均有极显著意义 (P <0 .0 0 0 1)。而不同发作类型组、头MRI(- )和头MRI(+)组的样波检出率和慢波异常率比较 ,差异无显著意义 (P <0 .0 5 )。借助头颅MRI检查 ,发现难治性病因主要是大脑发育不全、脑外伤和海马硬化等。结论 :难治性癫的EEG以慢波异常增多 ,样放电减少为特点 ,并且与发病年龄、病程长短有着密切关系。故常规EEG检查价值不大 ,应行Video -EEG监测和MRI检查 ,以便尽早发现致源和难治性病因     

myBrain: a novel EEG embedded system for epilepsy monitoring

The World Health Organisation has pointed that a successful health care delivery, requires effective medical devices as tools for prevention, diagnosis, treatment and rehabilitation. Several studies have concluded that longer monitoring periods and outpatient settings might increase diagnosis accuracy and success rate of treatment selection. The long-term monitoring of epileptic patients through electroencephalography (EEG) has been considered a powerful tool to improve the diagnosis, disease classification, and treatment of patients with such condition. This work presents the development of a wireless and wearable EEG acquisition platform suitable for both long-term and short-term monitoring in inpatient and outpatient settings. The developed platform features 32 passive dry electrodes, analogue-to-digital signal conversion with 24-bit resolution and a variable sampling frequency from 250?Hz to 1000?Hz per channel, embedded in a stand-alone module. A computer-on-module embedded system runs a Linux^® operating system that rules the interface between two software frameworks, which interact to satisfy the real-time constraints of signal acquisition as well as parallel recording, processing and wireless data transmission. A textile structure was developed to accommodate all components. Platform performance was evaluated in terms of hardware, software and signal quality. The electrodes were characterised through electrochemical impedance spectroscopy and the operating system performance running an epileptic discrimination algorithm was evaluated. Signal quality was thoroughly assessed in two different approaches: playback of EEG reference signals and benchmarking with a clinical-grade EEG system in alpha-wave replacement and steady-state visual evoked potential paradigms. The proposed platform seems to efficiently monitor epileptic patients in both inpatient and outpatient settings and paves the way to new ambulatory clinical regimens as well as non-clinical EEG applications.     

Mobile EEG in epilepsy

The sensitivity of routine EEG recordings for interictal epileptiform discharges in epilepsy is limited. In some patients, inpatient video-EEG may be performed to increase the likelihood of finding abnormalities. Although many agree that home EEG recordings may provide a cost-effective alternative to these recordings, their use is still not introduced everywhere. We surveyed Dutch neurologists and patients and evaluated a novel mobile EEG device (Mobita, TMSi). Key specifications were compared with three other current mobile EEG devices. We shortly discuss algorithms to assist in the review process. Thirty percent (33 out of 109) of Dutch neurologists reported that home EEG recordings are used in their hospital. The majority of neurologists think that mobile EEG can have additional value in investigation of unclear paroxysms, but not in the initial diagnosis after a first seizure. Poor electrode contacts and signal quality, limited recording time and absence of software for reliable and effective assistance in the interpretation of EEGs have been important constraints for usage, but in recent devices discussed here, many of these problems have been solved. The majority of our patients were satisfied with the home EEG procedure and did not think that our EEG device was uncomfortable to wear, but they did feel uneasy wearing it in public.     

A Comparison of Fractal Dimensions of EEG Time Series of Partial EpiIepsy

IntroductionTheDiagnosisofepilepsymainlydependsonclinicalcasehistoryandEEGexamination.Butalmostallthepatientsshownosignofepilepticattackwhenhavingaclinicaltest,duringtheinterparoxysmalpause,about5o%ofpatients'EEGhasnoepilepticeIectricalactivities.Therefore,lackofobjectiveevidencemakesitdifficuIttoformacorrectdiagnosisonadisease.Inrecentyears,thetheoryofnonIineardynamicshasbroughthopetotheresearchofbrainwave.Somecurrentresearchshowsthatwhenbrainsuffersepilepticaffection,someneurons'repetit…     

术中颅内电极脑电监测在联合术式治疗顽固性癫痫中的应用

目的：探讨术中颅内电极脑电监测在癫痫外科手术中的应用方法及价值。方法：回顾分析难治性癫痫患者78例术中采用颅内电极脑电监测,在病灶切除前对致痫灶区行皮层电极描记,记录有无痼样放电和范围,对痫灶部位进一步精确定位。采用联合手术方法进行病灶切除,之后再次或多次描记,以判断痼样放电有无减少或消失,对有痫样放电的皮层再次进行软膜下横切术。术后常规应用抗癫痫药物。结果：78例患者,术前均在预定的致痫灶局部记录到棘波、棘慢波、尖波和尖慢波;致痢灶切除后即时监测结果显示其中有7例痫样放电完全消失,56例痫样放电明显减少、背景波幅降低,15例在病灶周围仍散在有明显痫样放电,经再次处理后减少,所有患者均无神经功能损害加重。78例患者均随访6个月至4年,多数患者生活质量提高、精神状态改善。其中发作消失51例（65％）,发作明显减少（75％以上）16例（21％）,发作减少（50％以上）7例（9％）,发作无变化4例（5％）。总有效率为95％。结论：在癫痫外科手术中运用颅内电极进行脑电监测,能进一步明确致痂灶部位、监测异常波出现的范围及异常程度,指导手术中正确切除致痫灶,在癫痫外科治疗中具有一定的实用价值。     

Use of multiple dipole analysis for the classification of benign rolandic epilepsy

Summary The clinical literature has suggested that while the clinical features and presentation of benign rolandic epilepsy in children (BREC) are known, the neuronal mechanism of the epileptic focus is poorly understood. Classification of clinical subtypes is usually made by determining whether there are supplementary clinical signs of brain damage, in which case the epilepsy is classified as non-benign or "atypical". Studies of EEG findings in BREC have suggested that the source of the epilepsy is in the Rolandic fissure. We investigated dipole source modelling in 24 children, comparing the results of one and two dipole models. The results indicate that atypical BREC patients have a more complex distribution of dipoles and that single dipole fits may be more predictive of typical BREC than multiple dipole fits. The implications of these results are discussed.     

108例儿童良性癫癎的临床与脑电图分析

目的:探讨儿童良性癫癎的临床与脑电图(EEG)特征。方法:对108例临床明确诊断儿童良性癫癎的患儿进行清醒或睡眠EEG分析。结果:本组患儿EEG显示,棘波或尖波均出现在中央颞区或以颞区为主的部位,清醒时较为局限,入睡后放电频率明显增加,患儿临床发作停止时间要比EEG放电消失的早。结论:儿童良性癫癎是与年龄相关的癫癎综合征,EEG特征对该病诊断有重要价值,及时正确的诊断有助于治疗及判断预后。