j - JOUR T1 .基于同时立体-脑电记录的头皮脑电图放电的脑内相关性[j] . Neurology . JO - Neurology . 10.1212/WNL.0000000000207135首页Sp - 10.1212/ wnl.0000000000207135AU - Mickaël Ferrand AU - c dric Baumann AU - Olivier Aron AU - Jean-Pierre Vignal AU - Jacques Jonas AU - Louise Tyvaert AU - Sophie Colnat-Coulbois AU - Laurent Koessler博士AU - Louis Maillard Y1 - 2023/03/24 UR - http://n.n首页eurology.org/content/early/2023/03/24/WNL.0000000000207135.abstract N2 -背景和目的:颅侧脑电图能在多大程度上准确预测耐药癫痫术前评估中脑内癫痫发作的定位，目前尚不清楚。在这项研究中，我们的目的是定义均匀的头峰脑电图(基于他们的第一个头峰异常)，并评估他们的定位价值，同时记录头皮脑电图和立体脑电图。方法:我们回顾性地纳入了法国南希癫痫科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的连续的耐药局灶性癫痫患者。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:我们入组了129例患者。分层聚类分析得到头皮脑电首次修改后的6个特征。没有一个特定于单一的脑内定位。“正常脑电图”和“模糊脑电图”集群(早期肌肉伪影)各只有5名患者，并且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 -