颞叶癫痫脑电图特点ppt课件

activity (Wennberg et al., 2002), most commonly in the alpha-theta range (Spanedda
et al.,1997; Schiler et al., 1998) 4.Spike-and-wave activity, medium- to high- voltage spike-and-wave complexes
颞叶起始的发作期头皮脑电图特点
α、θ、δ节律范畴的放电活动 突发性快活动 可重复性癫痫式样放电 局灶性或广泛性电位低减或低平
颞叶起始的发作期头皮脑电图特点

源自文库颞叶内侧型癫痫发作起始放电：
最常见的表现形式为α或θ节律范畴(5～9Hz)的放电活 动（74-83%发作）； 发作起始无侧向性或弥漫性，可出现后续局灶显著性放 电（82-92%发作），常表现为节律性棘波；后续局灶性放 电出现在发作起始后30s之内，认为具有定侧/定位意义， 一般与发作起始的平均间隔时间为12.6～13.3s。
N. Foldvary; G. Klem, REEGT; J. Hammel; W. Bingaman; I. Najm; and H. Lüders. The localizing value of ictal EEG in focal epilepsy NEUROLOGY 2001;57:2022–2028

颞叶起始的发作结束后放电特点：

发作结束后脑电图是指发作期节律性放电活动消失；
发作结束后脑电图异常通常表现为δ节律的活动（频率： 1-3Hz，波幅是发作前背景活动波幅的50%以上）；
颞叶起始的发作，发作结束后δ活动出现的意义：单纯 部分性发作（55%），复杂部分性发作（85%），继发全身 强直-阵挛发作（100%）；常位于发作期癫痫放电最明显的 部位，提示癫痫发作起始同侧半球。
1.Low-voltage fast activity, clearly visible rhythmic activity>13Hz (Spanedda et
al.,1997;Lee et al., 2000;Wennberg et al., 2002), usually <10uv in initial amplitude (Faught et al., 1992)
Ekaterina Pataraia, Stefanie Lurger,, *Thomas Czech, *Klaus Novak, Liider Deecke, Christoph Baumgartner et al. Ictal Scalp EEG in Unilateral Mesial Temporal Lobe Epilepsy Epilepsia, 39(6):608-614, 1998

Mohammed M.S. Jan The value of postictal electroencephalogram in temporal lobe seizures Annals of Saudi Medicine, Vol 19, No 6, 1999
发作期颅内电极脑电图特点
P. Perucca, F. Dubeau and J. Gotman. Intracranial electroencephalographic seizure-onset patterns: effect of underlying pathology Brain 2014:137;183-196
颞叶癫痫脑电图特点
发作期头皮脑电图表现形式
1、α、θ、δ节律范畴的放电活动；
2、突发性快活动：放电频率≥13Hz； 3、抑制现象：放电活动的波幅≤10μv； 4、可重复性癫痫式样放电：连续出现3个或3个以上的 放电； 5、不规则放电：波形不规则、复合频率的放电； 6、伪迹干扰：癫痫式样的放电被伪迹干扰，难于判断 起始时间、形态和分布。
P. Perucca, F. Dubeau and J. Gotman. Intracranial electroencephalographic seizure-onset patterns: effect of underlying pathology Brain 2014:137;183-196
6.Burst suppression, brief bursts of medium- to high- voltage repetitive spikes alternating with brief periods of voltage
attenuation
7. Delta brush, rhythmic delta waves at 1-2Hz, with superimposed brief bursts of 20-30Hz activity overriding each delta wave.(premature infants-Clancy et al., 2003; anti-NMDA receptor encephalitis-Schmitt et al., 2012)
2.Low-frequency high-amplitude periodic spikes, high-voltage spiking at 0.5-2Hz
,lasting>5s (Spencer et al., 1992a; Velasco et al., 2000; Bartolomei et al., 2004) 3.Sharp activity at <=13Hz, low- to medium-voltage sharply-contoured rhythmic
typically occurring at a frequency of 2-4Hz (Wennberg et al., 2002)
5.Burst of high-amplitude polyspikes, a single brief burst of repetitive high-voltage spikes(Faught et al., 1992)