TY - JOUR T1 -基于同时立体脑电图记录的头皮脑电图发作放电的脑内相关因素JF - Neurology JO - Neurology DO - 10.1212/WNL.0000000000207135半岛投注体育官网Sp - 10.1212/ wnl.0000000000207135AU - Ferrand, Mickaël AU - Baumann, Cédric AU - Aron, Olivier AU - Vignal, Jean-Pierre AU - Jonas, Jacques AU - Tyvaert, Louise AU - Colnat-Coulbois, Sophie AU - Koessler博士，Laurent AU - Maillard, Louis Y1 - 2023/03/24 UR - http://n.neurol半岛投注体育官网ogy.org/content/early/2023/03/24/WNL.0000000000207135.abstract N2 -背景和目标:在术前评估耐药癫痫时，头皮脑电图能在多大程度上准确预测脑内癫痫发作的位置尚不清楚。在本研究中，我们旨在定义同质发作期头皮脑电图(基于首次发作期异常)，并使用同时记录的头皮脑电图和立体脑电图评估其定位价值。方法:我们回顾性地纳入了连续的耐药局灶性癫痫患者，他们同时有至少一次癫痫发作的立体脑电图和头皮脑电图记录，在法国南希的癫痫科。我们分析了每位患者的一次癫痫发作，并使用分层聚类分析对头皮脑电图上相似的癫痫发作特征进行分组，然后对其脑内相关性进行描述性分析。结果:本研究共纳入129例患者。分层聚类分析显示了头皮脑电图初次修改的6种特征。没有一种是特定于单一脑内定位的。“正常脑电图”和“模糊脑电图”簇(早期肌肉伪影)分别只包括5名患者，并对应于没有优先的脑内定位。 The “temporal discharge” cluster (n=46) was characterized by theta or delta discharges on ipsilateral anterior temporal scalp electrodes and corresponded to a preferential mesial temporal intra-cerebral localization. The “posterior discharge” cluster (n=42) was characterized by posterior ipsilateral or contralateral rhythmic alpha discharges or slow waves on scalp and corresponded to a preferential temporal localization. However, this profile was the statistically most frequent scalp EEG correlate of occipital and parietal seizures. The “diffuse suppression” cluster (n=9) was characterized by a bilateral and diffuse background activity suppression on scalp and corresponded to mesial, and particularly insulo-opercular, localization. Finally, the “frontal discharge” cluster (n=22) was characterized by bilateral frontal rhythmic fast activity or pre-ictal spike on scalp and corresponded to preferential ventrodorsal frontal intra-cerebral localizations.Discussion: Hierarchical cluster analysis identified six seizure profiles regarding the first abnormality on scalp EEG. None of them was specific of a single intra-cerebral localization. Nevertheless, the strong relationships between the “temporal”, “frontal”, “diffuse suppression” and “posterior” profiles and intra-cerebral discharges localizations may contribute to hierarchize hypotheses derived from ictal scalp EEG analysis regarding intra-cerebral seizure onset. ER -