难治性癫痫的致痫灶定位方法

癫痫患者中约20%~30%为难治性癫痫,手术是控制发作最有效的方法,常常可以改善患者的认知功能、行为学能力和生命质量。手术治疗的关键因素之一是准确定位致痫灶。目前有多种术前评估方法,这些方法分别从临床、神经电生理、影像学角度等提供致痫灶定位信息。目前定位致痫灶的金标准是颅内电极脑电图。建立多模式检测体系,最大程度综合各评估方法的优势,可提高致痫灶定位的准确性。近红外线波谱技术在癫痫中的应用以及致痫灶的生物标志物的研究将不断深入。     

Towards source volume estimation of interictal spikes in focal epilepsy using magnetoencephalography

Interictal spikes are a hallmark of cortical epileptogenicity; their spatial distribution in the cortex defines the so-called ‘irritative’ zone or spiking volume (SV). Delineating the SV precisely is a challenge during the presurgical evaluation of patients with epilepsy. Magnetoencephalography (MEG) recordings enable determination of the brain sources of epileptic spikes using source localization procedures. Most previous clinical MEG studies have relied on dipole modeling of epileptic spikes, which does not permit a volumetric estimation of the spiking cortex.In the present study, we propose a new source modeling procedure, Volumetric Imaging of Epileptic Spikes (VIES). In VIES, the SV is identified as the 3D region where sources of the high frequency activities (> 20 Hz) associated with epileptic spikes are distributed. We localized these sources using a beamforming approach (DICS, Dynamic Imaging of Coherent Neural Sources). To determine the optimal parameters and accuracy of the method, we compared the SV obtained by VIES with the SV defined by the invasive gold standard, intracranial stereotactic EEG recordings (SEEG), in 21 patients with focal epilepsy. Using rigorous validation criteria based on the exact anatomical location of SEEG contacts, we found that the overall sensitivity of VIES for detecting spiking SEEG contacts was 76% and its specificity for correctly identifying non-spiking SEEG contacts was 67%, indicating a good agreement between VIES and SEEG. Moreover, we found that classical dipole clustering was not informative in 9/21 patients, while VIES enable to delineate the SV in all patients. For the 12 patients having a SV delineated both with VIES and dipole clustering, VIES method had higher sensitivity and lower specificity. This proof-of-concept study shows that VIES is a promising approach to non-invasive estimation of the SV in focal epilepsy.     

Magnetoencephalographic yield of interictal spikes in temporal lobe epilepsy. Comparison with scalp EEG recordings

To compare magnetoencephalography (MEG) with scalp electroencephalography (EEG) in the detection of interictal spikes in temporal lobe epilepsy (TLE), we simultaneously recorded MEG and scalp EEG with a whole-scalp neuromagnetometer in 46 TLE patients. We visually searched interictal spikes on MEG and EEG channels and classified them into three types according to their presentation on MEG alone (M-spikes), EEG alone (E-spikes), or concomitantly on both modalities (M/E-spikes). The M-spikes and M/E-spikes were localized with MEG equivalent current dipole modeling. We analyzed the relative contribution of MEG and EEG in the overall yield of spike detection and also compared M-spikes with M/E-spikes in terms of dipole locations and strengths. During the 30- to 40-min MEG recordings, interictal spikes were obtained in 36 (78.3%) of the 46 patients. Among the 36 patients, most spikes were M/E-spikes (68.3%), some were M-spikes (22.1%), and some were E-spikes (9.7%). In comparison with EEG, MEG gave better spike yield in patients with lateral TLE. Sources of M/E- and M-spikes were situated in the same anatomical regions, whereas the average dipole strength was larger for M/E- than M-spikes. In conclusion, some interictal spikes appeared selectively on either MEG or EEG channels in TLE patients although more spikes were simultaneously identified on both modalities. Thus, simultaneous MEG and EEG recordings help to enhance spike detection. Identification of M-spikes would offer important localization of irritative foci, especially in patients with lateral TLE.     

Localization of interictal delta and epileptiform EEG activity associated with focal epileptogenic brain lesions

The present study was aimed at investigating the accuracy of electric source reconstruction in the presurgical evaluation of epilepsy patients. Spontaneous EEG activity of 14 patients with focal intracerebral epileptogenic lesions was analyzed by source reconstruction based on high-resolution EEG (64-channel system) and a boundary element method head model accounting for the individual head anatomy. Equivalent dipole modeling was applied to focal delta and interictal epileptiform activity. The localization results were validated quantitatively by comparison with the sites of the structural lesions. In 6 of 9 patients with focal delta activity, the maximum of dipole concentration was closer than 10 mm to the nearest lesion margin and mostly at the border or within pathologically altered cortical tissue. In all 11 patients showing interictal epileptiform activity, the localization results were found in the same lobe as the lesion. In almost half of them, they were closer than 10 mm to the lesion margin. Patients with larger distances (22-36 mm) mostly had hippocampal atrophy or sclerosis. Their dipole locations did not appear in the affected hippocampus, but in the adjacent temporal neocortex. In conclusion, electric source reconstruction applied to both abnormal slow and interictal epileptiform EEG activity seems to be a valuable additional noninvasive component in the multimodal presurgical evaluation of epilepsy patients.     

Comparison of magnetoencephalographic spikes with and without concurrent electroencephalographic spikes in extratemporal epilepsy

Interictal spikes in patients with epilepsy may be detected by either electroencephalography (EEG) (E-spikes) or magnetoencephalography (MEG) (M-spikes), or both MEG and EEG (E/M-spikes). Localization and amplitude were compared between E/M-spikes and M-spikes in 7 adult patients with extratemporal epilepsy to evaluate the clinical significance of MEG spikes. MEG and EEG were simultaneously measured using a helmet-shaped MEG system with planar-type gradiometers and scalp electrodes of the international 10-20 system. Sources of E/M-spikes and M-spikes were estimated by an equivalent current dipole (ECD) model for MEG at peak latency. Each subject showed 9 to 20 (mean 13.4) E/M-spikes and 9 to 31 (mean 16.3) M-spikes. No subjects showed significant differences in the ECD locations between E/M- and M-spikes. ECD moments of the E/M-spikes were significantly larger in 2 patients and not significantly different in the other 5 patients. The similar localizations of E/M-spikes and M-spikes suggest that combination of MEG and EEG is useful to detect more interictal spikes in patients with extratemporal epilepsy. The smaller tendency of ECD amplitude of the M-spikes than E/M-spikes suggests that scalp EEG may overlook small tangential spikes due to background brain noise. Localization value of M-spikes is clinically equivalent to that of E/M-spikes.     

Characteristics of postictal headache in patients with partial epilepsy

Migraine-like features sometimes characterize the headache that follows epileptic seizure (postictal headache, PIH). We compared patients with different types of epilepsy to investigate the association between migraine-like PIH and seizure type. Subjects comprised 364 patients with partial epilepsy. Epilepsy types were temporal lobe epilepsy (TLE, n = 177), frontal lobe epilepsy (FLE, n = 116), and occipital lobe epilepsy (OLE, n = 71). Patients participated in a structured interview pertaining to PIH as well as interictal headache and family history of migraine. Headaches were classified according to the International Headache Society criteria, which was modified for this study. Forty percent had PIH and 26% of these patients had migraine-like PIH. Migraine-like PIH occurred significantly more often in cases of TLE and OLE than in cases of FLE. In addition, the incidence of interictal migraine headache was significantly higher in patients with migraine-like PIH. These results suggest that migraine-like PIH is related to particular regions of epileptogenic focus and that susceptibility to migraine headache predisposes to migraine-like PIH.     

Hemodynamic changes preceding the interictal EEG spike in patients with focal epilepsy investigated using simultaneous EEG-fMRI

EEG-fMRI is a non-invasive technique that allows the investigation of epileptogenic networks in patients with epilepsy. Lately, BOLD changes occurring before the spike were found in patients with generalized epilepsy. The study of metabolic changes preceding spikes might improve our knowledge of spike generation. We tested this hypothesis in patients with idiopathic and symptomatic focal epilepsy.Eleven consecutive patients were recorded at 3 T: five with idiopathic focal and 6 with symptomatic focal epilepsy. Thirteen spike types were analyzed separately. Statistical analysis was performed using the timing of spikes as events, modeled with HRFs peaking between − 9 s and + 9 s around the spike. HRFs were calculated the most focal BOLD response. Eleven of the thirteen studies showed prespike BOLD responses. Prespike responses were more focal than postspike responses. Three studies showed early positive followed by later negative BOLD responses in the spike field. Three had early positive BOLD responses in the spike field, which remained visible in the later maps. Three others had positive BOLD responses in the spike field, later propagating to surrounding areas. HRFs peaked between − 5 and + 6 s around the spike timing. No significant EEG changes could be identified prior to the spike.BOLD changes prior to the spike frequently occur in focal epilepsies. They are more focal than later BOLD changes and strongly related to the spike field. Early changes may result from increased neuronal activity in the spike field prior to the EEG spike and reflect an event more localized than the spike itself.     

Localizing epileptogenic regions in partial epilepsy using three-dimensional statistical parametric maps of background EEG source spectra

This preliminary study sought to localize epileptogenic regions in patients with partial epilepsy by analysis of interictal EEG activity utilizing variable resolution electromagnetic tomography (VARETA), a three-dimensional quantitative electroencephalographic (QEEG) frequency-domain distributed source modeling technique. The very narrow band (VNB) spectra spanned the frequency range 0.39 Hz to 19.1 Hz, in 0.39 Hz steps. These VNB spectra were compared to normative data and transformed to provide Z-scores for every scalp derivation, and the spatial distributions of the probable EEG generators of the most abnormal values were displayed on slices from a probabilistic MRI atlas. Each voxel was color-coded to represent the significance of the deviation relative to age appropriate normative values. We compared the resulting three-dimensional images to the localization of epileptogenic regions based on invasive intracranial EEG recordings of seizure onsets. The VARETA image indicated abnormal interictal spectral power values in regions of seizure onset identified by invasive monitoring, mainly in delta and theta range (1.5 to 8.0 Hz). The VARETA localization of the most abnormal voxel was congruent with the epileptogenic regions identified by intracranial recordings with regard to hemisphere in all 6 cases, and with regard to lobe in 5 cases. In contrast, abnormal findings with routine EEG agreed with invasive monitoring with regard to hemisphere in 3 cases and with regard to lobe in 2 cases. These results suggest that analysis of background interictal EEG utilizing distributed source models should be investigated further in clinical epilepsy.     

难治性颞叶癫痫病灶中Cx32与Cx43表达的研究

目的分析难治性癫痫患者脑组织中缝隙连接蛋白32（Cx32）、连接蛋白43（Cx43）表达,探讨缝隙连接在癫痫发生发展中的作用。方法对30例难治性癫痫患者（癫痫灶组）进行皮质电图监测下手术切除痫灶,采用免疫组化染色法（二步法）检测癫痫灶及10例周边脑组织（周边脑组织组）Cx32、Cx43表达,并进行统计学分析。结果癫痫灶组及周边脑组织组Cx43、Cx32均有表达,Cx43在癫痫灶组中表达明显增多（U=4．066,P〈0．001）;而癫痫灶组及周边脑组织组中Cx32的表达比较差别无统计学意义（U=1．866,P〉0．05）。结论缝隙连接在癫痫发生、发展中有重要作用,长期癫痫发作可造成神经元凋亡。     

质子磁共振波谱分析结合128导视频脑电图对手术治疗顽固性癫痫致痫灶的定位价值

目的:探讨质子磁共振波谱(1H-MRS)分析结合128导视频脑电图(VEEG)、术中皮层或深部电极脑电图(ECoG)对致痫灶定侧定位的价值.方法:选择15例顽固性癫痫为研究对象.术前行VEEG后行1H-MRS检查,获得NAA/(Cr+Cho)比值.术中行ECoG描记验证.以术后病理为标准,将异常放电区域、伴海马硬化的术前'H-MRS与同患者对侧检查结果进行对照,分析1H-MRs与皮层异常放电的关系.结果:病理回报15例均有皮质发育不良,海马硬化9例.切除病灶前行病灶周边ECoG描记.15例均发现异常放电.术中ECoG异常放电区域NAA/(Cr+Cho)平均比值为0.78±0.27,同一患者对侧比值为0.94±0.22,差异有显著性意义(P<0.05).伴海马硬化者NAA/(Cr+Cho)平均比值为0.55±0.14,同一患者对侧比值为0.71±0.09,差异有显著性意义(P<0.05).1H-MRS与VEEG一致率为86.67%.结论:-H.MRs可对海马硬化进行早期诊断,提高了海马硬化诊断的敏感度.1H-MRS结合128导VEEG可提高致痫灶定位的准确性.     

伴中央颞区棘波儿童良性癫痫的脑电图分析

目的探讨伴中央颞区棘波儿童良性癫痫(BECT)患儿的脑电图特征和临床意义。方法选择2013年6月至2014年7月BECT患儿22例,分析其脑电图表现及发作时间。结果 22例全部在睡眠中出现癫痫样波,在清醒描记时出现15例;癫痫样波仅出现在中央和(或)颞区者17例,除见于中央、颞区外亦散在性出现于其他脑区者5例;左侧中央颞区明显者9例,右侧中央颞区明显者8例;晚上睡眠发作者10例,中午睡眠发作2例,晨起觉醒前发作者2例,晚上和觉醒前均有发作者8例。结论 BECT是一种特殊癫痫综合征,预后良好,认识其临床和EEG演变的特点及规律可提高对BECT的检出率。     

Comparative assessment of health-related quality of life with and without anticonvulsant therapy in patients with childhood epilepsy with centrotemporal spikes

ObjectiveTo estimate anti-seizure medication (ASM) treatment burden and its effects on health-related quality of life (HRQOL) in new-onset childhood epilepsy with centrotemporal spikes (CECTS) using different treatment approaches in Kazakhstan.MethodsForty-three patients were followed prospectively during 2015 to 2020 for at least 2 years. Patients were divided into three groups: (1) history of ≤3 seizures (n = 32); (2) ≥4 seizures (n = 6); (3) cerebral palsy coexisting with CECTS (n = 5). The first group was subdivided into treated (n = 8) and observed (n = 24) subgroups. The shortened Quality of Life in Childhood Epilepsy Questionnaire (QOLCE-55) was completed by parents after 6 months of follow-up.ResultsAt the end of the study, all children had a sustained remission from seizures for at least 2 years. Differences were identified in emotional, social, and physical subscales between patients in the low seizure frequency group. Signs of low self-esteem, anxiety, depression, limited social interaction owing to pharmacotherapy, painful medical procedures, and stigma were reasons for decreased HRQOL in the treated subgroup. Overall HRQOL in treated (89.2 ± 5.2) patients was significantly decreased compared with observed children with low seizure frequency (98.0 ± 3.0).ConclusionASM therapy does not necessarily improve and may decrease HRQOL in children with low seizure frequency CECTS.     

Endothelial function in patients with migraine during the interictal period

OBJECTIVES: The aim of this study is to evaluate endothelial function in migraineurs subjects during the asymptomatic period. BACKGROUND: Migraine has been proposed as a risk factor for cerebrovascular events. The underlying mechanisms that relate these 2 pathologies are unknown. Nitric oxide (NO) has been proposed as the final causative molecule of migraine. Increased NO metabolites concentrations have been reported in migraineurs subjects during acute migraine attacks, but there is no evidence indicating alterations in endothelial NO release during the symptom free period in theses subjects. DESIGN AND METHODS: Fifty migraineurs subjects and 25 healthy subjects matched by gender and age were included. Every subject underwent a complete examination that included medical history, physical examination, resting electrocardiogram, forearm flow-mediated vasodilation (FMD), blood determinations of fasting nitrates and nitrites (NO(2) (-)+ NO(3) (-)), glucose, lipid profile, creatinine, C-reactive protein, and blood cell count. RESULTS: No differences in FMD or NO(2) (-)+ NO(3) (-) were detected among groups. The only difference between migraineurs and control subjects was a higher mean blood pressure 92.1 (8.8) mmHg versus 86.7 (8.2) mmHg P= .01. CONCLUSION: The endothelial function is not altered during the interictal period in migraineurs subjects.     

动脉自旋标记成像用于平扫MR阴性发作间期癫痫患儿

目的观察动脉自旋标记(ASL)成像对平扫MR阴性的发作间期癫痫患儿的诊断价值。方法纳入56例平扫MR未显示结构异常的发作间期癫痫患儿,采用视觉分析法将ASL显示灌注异常分为低灌注或高灌注,与临床及视频脑电图(VEEG)定位癫痫灶结果进行一致性检验,并分析ASL异常灌注的影响因素。结果 56例中,52例(52/56,92.86%)为癫痫局灶性发作,4例(4/56,7.14%)为全身性发作。39例(39/56,69.64%)ASL显示灌注异常,37例(37/52,71.15%)为局灶性发作、2例(2/4,50.00%)为全身性发作;其中20例(20/39,51.28%)ASL显示灌注异常定位与临床定位癫痫灶完全一致,9例(9/39,23.08%)部分一致;ASL定位癫痫灶与临床定位结果具有中等一致性(Kappa=0.46,P<0.01)。于发作1天内行ASL是唯一与MR和临床定位癫痫灶一致性相关的因素(P<0.05)[OR=3.81,95%CI(1.16,12.44),P=0.027]。结论 ASL技术可于发作间期有效定位平扫MR阴性癫痫患儿的癫痫灶。     

联合应用SPECT、EEG、MRI定位癫痫致痫灶53例分析

目的探讨单光子发射计算机断层(SPECT)脑血流灌注显像联合动态脑电图和(或)视频脑电图、磁共振成像(MRI)检查在定位癫痫致痫灶中的意义.方法对53例癫痫患者于发作间期进行99mTc-ECD局部脑血流灌注显像,并与同期动态脑电图和(或)视频脑电图、MRI检查、术中皮层脑电图检查结果进行对比分析.结果 SPECT脑血流灌注显像诊断癫痫的阳性率为88.68%,与脑电图(EEG)检查的阳性率(86.79%)一致,但二者均明显高于MRI检查阳性率(33.96%),且STECT联合EEG检查,阳性率可提升至98.11%(52/53),明显高于SPECT或EEG单独检查的阳性率;在定位致痫灶过程中,SPECT脑血流显像与EEG在致痫灶的定位上具有良好的吻合性,其符合率(包括定位一致及基本一致者)为60.37%,明显高于SPECT与MRI检查的符合率(35.85%)及EEG与MRI的符合率(32.07%);经术中皮层脑电图检查证实SPECT定位致痫灶的准确率达83.33%,若与EEG、MRI联合分析则其定位准确率提升至95.8%(23/24).结论 SPECT脑血流灌注显像不仅能灵敏地检出癫痫灶,且能较准确地定位诊断癫痫灶,与EEG和MRI的联合应用可大大提高其诊断的灵敏度和定位的准确性.     

3例酒精戒断综合征伴癫痫的护理

酒精戒断综合征指长期或大量饮酒过程中相对或绝对停酒的时间,产生的一系列精神与躯体症状［1］。酒精戒断综合征伴癫痫的发生是由于断酒后血中酒精浓度急剧发生变化,引起血清中镁、钾离子浓度降低,动脉血pH值上升,这是光诱发肌阵挛阈值降低,导致痉挛发作［2］。我院对3例酒精戒断综合征伴癫痫患者进行护理,取得了较好效果。 1临床资料 本组男性患者3例,年龄40～56岁,平均年龄46．6岁。饮酒时间6～24年。饮酒量：白酒（50度以上）0．5～1．5L／d。患者体质消瘦、营养状况较差、手抖、步态不稳、多汗、心悸、纳差、失眠,2例伴有明显的幻觉。1例患者于入院当日晚出现癫痫发作,呈持续状态,在6 h内连续发作17次,每次抽搐时间约45～60 s。2例患者于入院次日出现癫痫发作,其中1例患者发作2次,2次抽搐时间分别为47s、56s。2次发作间隔约1h ,另1例患者出现1次阵挛发作,抽搐时间约为57s。3例患者经治疗后均好转出院。     

伴有中央颞区棘波的良性癫痫患儿认知功能事件相关电位研究

目的研究伴有中央颞区棘波的儿童良性癫痫(BCECTS)患儿是否存在认知功能损害以及探讨评价认知功能损害的的敏感指标。方法21例BCECTS儿童作为患者组,与其年龄、性别、受教育程度及家庭社会经济状况匹配的健康对照21名。成对的个位数字(S1和S2)依次呈现,要求受试者判断两个数字相同或不同。同步记录事件相关电位。结果两组在两个数字数值不同时都可以诱发出冲突负波N270。患者组N270的峰潜伏期均较对照组延长,波幅下降,而患者组P300的潜伏期及波幅与对照组无显著性差异。结论BCECTS儿童存在认知功能的损害。N270在评价轻度认知功能损害方面,敏感性高于P300。     

成人颞叶癫痫患者发作间期18F-FDG PET/CT脑代谢显像与术后疗效的关系

目的:探讨成人颞叶癫痫患者发作间期18F-FDG PET/CT脑代谢显像与术后疗效的关系。方法:回顾性分析2013年8月-2018年3月于北部战区总医院接受发作间期18F-FDG PET/CT脑代谢显像,且颞叶均为阳性表现,并于我院神经外科接受手术治疗的颞叶癫痫患者62例,其中女22例,男40例,年龄范围18~58岁,平均(31.48±10.48)岁,按照病灶的数目(单发/多发)、侧别(单侧大脑半球/双侧大脑半球)将PET/CT图像分为单侧单发低代谢病灶组(病灶仅存在于单侧大脑半球颞叶中)、单侧多发低代谢病灶组(病灶存在于颞叶及其他同侧非颞叶中)、双侧多发低代谢病灶组(病灶分布于双侧颞叶或一侧颞叶与对侧非颞叶中),术后随访12~55(30.50±13.42)月,中位随访时间28.5月,根据Engel分级分为疗效满意组(EngelⅠ)45例和疗效不满意组(EngelⅡ+EngelⅢ+EngelⅣ)17例,对两组患者PET/CT图像中病灶的数目、侧别进行单因素分析,并对有统计学意义的因素进行Logistic回归分析,总结出18F-FDG PET/CT图像的代谢改变图型与成人颞叶癫痫患者术后预后的关系。结果:18F-FDG PET/CT脑代谢显像显示病灶的数目、侧别单因素分析结果均具有统计学意义,P值分别为0.001、0.02,进而进行Logistic回归分析,结果显示病变的数目与预后具有很强的相关性(OR=7.219,95%CI:0.339~8.676,P=0.008),而病变的侧别与预后不具有相关性(OR=1.714,95%CI:1.691~30.809,P=0.515)。结论:18F-FDG PET/CT脑代谢显像可用于预测成人颞叶癫痫患者的术后疗效,单发低代谢病灶的患者手术疗效较好,低代谢病灶的数目是手术预后疗效的独立预测因素。     

Clinical and electroencephalogram characteristics and treatment outcomes in children with benign epilepsy and centrotemporal spikes

BACKGROUNDEpilepsy is a syndrome characterized by transient, rigid, paroxysmal, and repetitive central nervous system dysfunction. Prevention, control, and improvement of cognitive and behavioral dysfunction are of great significance for improving the patients’ intellectual development and quality of life. Electroencephalograms (EEG) can predict an accelerated decline in cognitive function.AIMTo determine the clinical and EEG characteristics and treatment results of benign epilepsy in spiking children.METHODSA total of 106 cases of benign epilepsy in children with myocardial spines treated at our hospital from January 2017 to January 2020 were selected. Differences in clinical data and EGG characteristics between treatment-effective/-ineffective patients were analyzed, and children’s intellectual development before and after treatment evaluated using the Gesell Development Diagnostic Scale.RESULTSEEG showed that the discharge proportion in the awake and sleep periods was 66.04%, and the peak/peak discharge was mainly single-sided, accounting for 81.13%, while the discharge generalization accounted for 31.13%. There was no significant difference in any of these variables between sexes and ages (P > 0.05). The proportion of patients with early onset (< 5 years old) and seizure frequency > 3 times/half a year was 40.00% and 60.00%, respectively; the incidence rate and seizure frequency in the younger age group (< 5 years old) were significantly higher than those in the treatment-effective group (P < 0.05), while the discharge index was significantly lower than that in the treatment-effective group (P < 0.05). The discharge index was negatively correlated with fine motor skill and language development (r = -0.274 and -0.247, respectively; P < 0.05), but not with the rest (P > 0.05). Logistic regression analysis showed that low age onset (< 5 years old) and seizure frequency were the factors affecting ineffective-treatment of benign epilepsy in children (odds ratio = 11.304 and 5.784, respectively; P < 0.05). The discharge index of the responsive group after treatment was significantly lower than that of the unresponsive group (P < 0.05). However, there was no significant difference between groups after treatment in gross and fine motor skills, adaptability, language, and personal social development (P > 0.05).CONCLUSIONThe EEG of children with benign epilepsy due to spinal wave in central time zone has characteristic changes, and the therapeutic effect is influenced by age of onset and attack frequency.     

伴中央颞区棘波儿童良性癫痫海马功能连接改变的fMRI研究

目的探讨伴中央颞区棘波儿童良性癫痫(benign epilepsy with centrotemporal spikes,BECTS)海马不同分区与全脑功能连接的变化,分析其潜在的神经机制和临床指导价值.材料与方法前瞻性收集44例BECTS患儿和35例年龄、性别匹配的健康对照的脑静息态血氧水平依赖功能磁共振成像(blo...