头皮脑电图继发双侧同步(癎)样放电的特点及其临床意义

目的:探讨局灶性癫(癎)患者头皮脑电图(EEG)上继发双侧同步(癎)样放电(SBSD)的表现特点及临床意义.方法:回顾性地分析自2002年3月至2006年3月,于我研究所接受治疗的所有局灶性癫(癎)患者的EEG资料,排除所有颞叶癫(癎),共32例患者的术前EEG上均存在SBSD表现.对这些患者的发作间期与发作期EEG结果进行分析研究.结果:32例患者中,SBSD起源于额区者20例,枕区者10例,顶区者2例.SBSD可表现为棘或尖波、棘慢复合波与快节律三种类型,以棘慢复合波最为常见,占63%.SBSD发作间期较为常见的特点是双侧存在时间差,SBSD始于EEG局灶性异常改变以及局限性慢波一侧;53%的病人发作期EEG表现为局灶性起源.结论:SBSD在局灶性癫(癎)患者中并不少见,而且以额叶最为常见.通过分析SBSD波形的各个特点,有助于判断SBSD原发灶侧别,并与全面性癫(癎)相鉴别,对癫(癎)外科的术前评估具有非常重要的临床意义.

The characteristics and clinical significance of secondary bilateral synchronous discharges on scalp EEG

Objective:To discuss the characteristics and clinical significance of secondary bilateral synchronous discharges(SBSD) on the scalp electroencephalogram (EEG) in patients with intractable focal epilepsies. Methods: We studied 32 patients whose scalp EEGs showed SBSD when they received treatment in our institute from March 2002 to March 2006. The patients with temporal lobes lesion were excluded in this study. The characteristics of SBSD on presurgical interictal and ictal scalp EEGs were analysed, and then the differential diagnoses and significance of SBSD were discussed. Results: Of the 32 patients, 20 patiients had SBSD on frontal lobes. 10 on occipital lobes. 2 on parietal lobes. Three forms of SBSD were found: spikes or sharp waves, spike and wave discharges (the most commonly seen, taking up 63%)and fast activities. The characteristics of SBSD included interhemispheric small time difference, focal epileptic discharges before SBSD bursts and focal slow waves on the primary site of SBSD. On the other hand, the origin of focal ictal epileptic activities on EEGs could be found in 53% of the patients with SBSD. Conclusions; SBSD is frequently seen in patients with intractable focal epilepsy, especially in frontal lobe epilepsy. In careful analysis of several characteristics of SBSD, be able to differentiate SBSD from generalized epilepsy and find out the primary side of SBSD , which is of great importance before epilepsy surgery.