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1.
梁亮  徐樊  井哓荣  王超  梁秦川  郭恒  孟强  李焕发  张华  高国栋 《生物磁学》2011,(8):1498-1501,1525
目的:探讨长程颅内电极监测及电刺激方法,在感觉运动区皮质发育不良的难治性癫痫外科手术评估中的意义。方法:筛选MRI提示的皮质发育不良区域与重要功能区-感觉运动区位置关系密切的11例难治性癫痫患者,且头皮长程视频脑电监测及PET检查也初步提示癫痫发作与皮质发育不良所在脑区有关,在可疑脑区放置颅内电极,然后进行颅内电极长程视频脑电监测及电刺激检测,对癫痫起源位置及功能区定位,明确癫痫发作起源区域与感觉运动功能区的解剖学关系,在定位结果指导下进行切除术。结果:11例中3例位于左侧半球,8例位于右侧半球,11例感觉运动功能区皮质分布均存在不同程度变异,7例癫痫发作起源区域与感觉运动功能区一定范围重叠,其中5例与感觉区重叠,该5例切除了起源区域与发作有关的部分感觉区,2例部分致痫灶与运动区重叠,该2例仅切除了除与发作有关的运动区以外的癫痫起源区域,4例癫痫发作起源区域与感觉运动功能区相对独立,该4例完全切除癫痫发作起源区域;手术后6例患者发作消失,2例患者发作频率减少90%以上,1例癫痫发作控制无效,2例患者发生部分感觉缺失,但对生活无明显影响。结论:在皮质发育不良的癫痫患者中,有较高比例的病人伴有功能区皮层分布的变异,长程颅内电极监测及电刺激能够实现癫痫起源区域及功能区精确定位,明确功能区变异情况,对于指导病灶切除,避免损伤功能区皮质,减少术后并发症具有重要意义。  相似文献   

2.
目的:探讨长程颅内电极监测及电刺激方法,在感觉运动区皮质发育不良的难治性癫痫外科手术评估中的意义。方法:筛选MRI提示的皮质发育不良区域与重要功能区-感觉运动区位置关系密切的11例难治性癫痫患者,且头皮长程视频脑电监测及PET检查也初步提示癫痫发作与皮质发育不良所在脑区有关,在可疑脑区放置颅内电极,然后进行颅内电极长程视频脑电监测及电刺激检测,对癫痫起源位置及功能区定位,明确癫痫发作起源区域与感觉运动功能区的解剖学关系,在定位结果指导下进行切除术。结果:11例中3例位于左侧半球,8例位于右侧半球,11例感觉运动功能区皮质分布均存在不同程度变异,7例癫痫发作起源区域与感觉运动功能区一定范围重叠,其中5例与感觉区重叠,该5例切除了起源区域与发作有关的部分感觉区,2例部分致痫灶与运动区重叠,该2例仅切除了除与发作有关的运动区以外的癫痫起源区域,4例癫痫发作起源区域与感觉运动功能区相对独立,该4例完全切除癫痫发作起源区域;手术后6例患者发作消失,2例患者发作频率减少90%以上,1例癫痫发作控制无效,2例患者发生部分感觉缺失,但对生活无明显影响。结论:在皮质发育不良的癫痫患者中,有较高比例的病人伴有功能区皮层分布的变异,长程颅内电极监测及电刺激能够实现癫痫起源区域及功能区精确定位,明确功能区变异情况,对于指导病灶切除,避免损伤功能区皮质,减少术后并发症具有重要意义。  相似文献   

3.
4.
The clinical seizure pattern, particularly the initial phenomena, plus the EEG, when satisfactory recording of the seizure onset can be achieved, determine the primary localization of epileptic phenomena. The EEG has also demonstrated, by the presence of interictal epileptiform spike discharges, the presence of a second-order localization of epileptic phenomena, namely, the location and extent of cortex adjacent to the site of origin of the neuronal seizure discharge that is recruited into action in a clinical epileptic seizure. Experience with cortical resection in the treatment of focal epilepsy has demonstrated the importance of a third-order localization of epileptic phenomena, namely, how much of the potentially epileptogenic cortex must be excised in order to produce a satisfactory reduction of the seizure tendency.  相似文献   

5.
Patients experiencing solitary unprovoked epileptic seizure have different risks of recurrence. The possible risk factors include in particular: structural cerebral lesion and its cause, history of febrile seizures, family history of epilepsy, the type of seizure, epileptiform EEG discharges and the problem of initiation or (or not initiation) of antiepileptic treatment after the first paroxysm. The factors shown above were evaluated in a group of 30 patients with solitary unprovoked epileptic seizure. Regarding recurrence of epileptic seizure, the only significant factor appeared to be initiation of treatment after the first unprovoked paroxysm (p<0.001). We observed a 30% and 33.33% risk of recurrence following the initial epileptic seizure in patients after the first unprovoked seizure in less than 1 and 3 years, respectively.  相似文献   

6.
The objective of this work is to identify similarities in the spatio-temporal dynamics of epileptic seizures, record with scalp EEG. A comprehensive method is proposed and applied in EEG of the patients who suffer from temporal lobe epilepsy. The method is based on the computation of the time-varying degree of non linear correlation between scalp electrodes at seizure onset and during seizure spread, determined by a nonlinear regression analysis. The quantification and coding of these similarity relations allow the comparison between two epileptic networks. Results show that reproducible patterns may be extracted from different seizures of the same patient and confirm the existence of different subtypes of temporal lobe epilepsy.  相似文献   

7.
Multiway analysis of epilepsy tensors   总被引:1,自引:0,他引:1  
MOTIVATION: The success or failure of an epilepsy surgery depends greatly on the localization of epileptic focus (origin of a seizure). We address the problem of identification of a seizure origin through an analysis of ictal electroencephalogram (EEG), which is proven to be an effective standard in epileptic focus localization. SUMMARY: With a goal of developing an automated and robust way of visual analysis of large amounts of EEG data, we propose a novel approach based on multiway models to study epilepsy seizure structure. Our contributions are 3-fold. First, we construct an Epilepsy Tensor with three modes, i.e. time samples, scales and electrodes, through wavelet analysis of multi-channel ictal EEG. Second, we demonstrate that multiway analysis techniques, in particular parallel factor analysis (PARAFAC), provide promising results in modeling the complex structure of an epilepsy seizure, localizing a seizure origin and extracting artifacts. Third, we introduce an approach for removing artifacts using multilinear subspace analysis and discuss its merits and drawbacks. RESULTS: Ictal EEG analysis of 10 seizures from 7 patients are included in this study. Our results for 8 seizures match with clinical observations in terms of seizure origin and extracted artifacts. On the other hand, for 2 of the seizures, seizure localization is not achieved using an initial trial of PARAFAC modeling. In these cases, first, we apply an artifact removal method and subsequently apply the PARAFAC model on the epilepsy tensor from which potential artifacts have been removed. This method successfully identifies the seizure origin in both cases.  相似文献   

8.
The effect of the noradrenergic neurotoxin N-(2-chloroethyl)-N-ethyl-2-bromobenzylamine (DSP-4) on electroencephalographic activity (EEG) was studied in the model of chronic focal epilepsy induced by intracortical injection of FeCl3 in the rat. EEG activity was recorded from the epileptogenic focus (ipsilateral and contralateral) in chronic experiments before and after DSP-4 treatment. In some experiments EEG activity was also simultaneously recorded from the cortical epileptogenic focus and locus coeruleus before and after DSP-4 treatment to study the effect of iron-induced seizure activity and of DSP-4 on the locus coeruleus electrical activity. The results showed that DSP-4 aggravated the iron-induced epileptiform activity as well as the locus-coeruleus electrical activity. The data also showed that, induction of epilepsy by FeCl3 is accompanied by enhancement of the locus coeruleus electrical activity. Our study demonstrates that DSP-4 intensifies and modifies the epileptic activity in the iron-induced chronic epilepsy model and that the effects of toxin persist for a longer duration.  相似文献   

9.
Epilepsy is a neurological disorder characterized by spontaneous, recurrent and paroxysmal cerebral discharge, clinically leading to persistent alterations in function and morphology of neurons. Oxidative stress is one of possible mechanisms in the pathogenesis of epilepsy. Oxidative stress resulting from mitochondrial dysfunction gradually disrupts the intracellular calcium homeostasis, which modulates neuronal excitability and synaptic transmission making neurons more vulnerable to additional stress, and leads to neuronal loss in epilepsy. In addition, the high oxidative status is associated with the severity and recurrence of epileptic seizure. Hence, treatment with antioxidants is critically important in epileptic patients through scavenging the excessive free radicals to protect the neuronal loss. In this review, we reviewed the recent findings that focus on the role for antioxidants in prevention of mitochondrial dysfunction and the correlation between oxidative status and disease prognosis in patients with epilepsy.  相似文献   

10.
The therapeutic goal in the neurosurgical treatment of medically intractable epilepsy is complete seizure control, for both biologic and psychosocial reasons. Cortical resections are more likely to accomplish this than other surgical alternatives for epilepsy. Although abnormalities on new imaging techniques (CT, positron emission scanning) aid in identifying the epileptic focus, interictal epileptiform EEG changes remain the main indicator of focal origin of the seizures. Where this is equivocal, direct brain recording of spontaneous seizures with subdural electrodes is of value in identifying the side and lobe of seizure onset. The cortical resection is then tailored by the extent of the interictal electrocorticographic abnormalities and functional identification of essential areas such as those for language, using an electrical stimulation mapping technique, under local anesthesia. With this approach, half of the patients with temporal lobe foci are seizure-free since the time of operation, over two-thirds become so with time, and over three-quarters have at least very major reductions in seizure frequency.  相似文献   

11.
The concept of focal epilepsies includes a seizure origin in brain regions with hyper synchronous activity (epileptogenic zone and seizure onset zone) and a complex epileptic network of different brain areas involved in the generation, propagation, and modulation of seizures. The purpose of this work was to study functional and effective connectivity between regions involved in networks of epileptic seizures. The beginning and middle part of focal seizures from ictal surface EEG data were analyzed using dynamic imaging of coherent sources (DICS), an inverse solution in the frequency domain which describes neuronal networks and coherences of oscillatory brain activities. The information flow (effective connectivity) between coherent sources was investigated using the renormalized partial directed coherence (RPDC) method. In 8/11 patients, the first and second source of epileptic activity as found by DICS were concordant with the operative resection site; these patients became seizure free after epilepsy surgery. In the remaining 3 patients, the results of DICS / RPDC calculations and the resection site were discordant; these patients had a poorer post-operative outcome. The first sources as found by DICS were located predominantly in cortical structures; subsequent sources included some subcortical structures: thalamus, Nucl. Subthalamicus and cerebellum. DICS seems to be a powerful tool to define the seizure onset zone and the epileptic networks involved. Seizure generation seems to be related to the propagation of epileptic activity from the primary source in the seizure onset zone, and maintenance of seizures is attributed to the perpetuation of epileptic activity between nodes in the epileptic network. Despite of these promising results, this proof of principle study needs further confirmation prior to the use of the described methods in the clinical praxis.  相似文献   

12.
Summary The marriage rate of epileptic patients was 62% in males und 78% in females. Compared with the rates in the general population, the male patients had a 15% lower rate, but there was no difference in females. There were 263 patients with at least one offspring selected for the study. There were 243 sons and 272 daughters (506 total, 1.9 per patient). Distribution by types of seizure was awakening grand mal, absence or myoclonic petit mal in 24%, grand mal with no aura in 21%, grand mal during sleep in 23%, diffuse grand mal in 7%, grand mal with aura in 13%, psychomotor seizure in 9%, and focal seizure in 3%. The probands were composed of 79% idiopathic and 21% symptomatic in pathogenetic classification. An epileptic EEG abnormality was demonstrated in 22% of male and 44% of female probands.The incidence of seizures among offspring was 2.4% (4.2% age-corrected) in a narrow sense (epilepsy) and 9.1% in a broad sense including febrile convulsions. The latter morbidity was 11.0% for the idiopathic and 3.2% for the symptomatic group; 11.0% for female and 6.9% for male probands; 10.2% for sons and 8.1% for daughters. The figure was higher for the probands with the age range at onset of seizure of 0–4 years (20.6%) and 20–29 years (12.6%) than for those with other age ranges; higher for those with awakening grand mal, absence, myoclonic petit mal, or grand mal with no aura than for those with other types of seizure; and higher for those with family history of epilepsy than those without it.Possible correlation of types of seizure between probands and offspring was demonstrated. Thirty-seven percent of offspring exhibited epileptic EEG abnormalities, and the ratio of epileptic EEG abnormalities to clinical manifestation is about 4:1.Possible existence of familial aggregation of EEG abnormalities and of two kinds of families with large or small epileptic predisposition was indicated.The importance of the role of hereditary and environmental factors in epileptic pathogenesis is proved, and the results of an investigation of congenital malformation among offspring of epileptic mothers are presented. These results were considered to be useful for genetic counseling of epileptic patients.  相似文献   

13.
Epilepsy is an abnormal brain state in which a large population of neurons is synchronously active, causing an enormous increase in metabolic demand. Recent investigations using high-resolution imaging techniques, such as optical recording of intrinsic signals and voltagesensitive dyes, as well as measurements with oxygen-sensitive electrodes have elucidated the spatiotemporal relationship between neuronal activity, cerebral blood volume, and oximetry in vivo. A focal decrease in tissue oxygenation and a focal increase in deoxygenated hemoglobin occurs following both interictal and ictal events. This “epileptic dip” in oxygenation can persist for the duration of an ictal event, suggesting that cerebral blood flow is inadequate to meet metabolic demand. A rapid focal increase in cerebral blood flow and cerebral blood volume also accompanies epileptic events; however, this increase in perfusion soon (>2 s) spreads to a larger area of the cortex than the excitatory change in membrane potential. Investigations in humans during neurosurgical operations have confirmed the laboratory data derived from animal studies. These data not only have clinical implications for the interpretation of noninvasive imaging studies such as positron emission tomography, single-photon emission tomography, and functional magnetic resonance imaging but also provide a mechanism for the cognitive decline in patients with chronic epilepsy.  相似文献   

14.
The past decade has seen astounding discoveries about resting-state brain activity patterns in normal brain as well as their alterations in brain diseases. While the vast majority of resting-state studies are based on the blood-oxygen-level-dependent (BOLD) functional MRI (fMRI), arterial spin labeling (ASL) perfusion fMRI can simultaneously capture BOLD and cerebral blood flow (CBF) signals, providing a unique opportunity for assessing resting brain functions with concurrent BOLD (ccBOLD) and CBF signals. Before taking that benefit, it is necessary to validate the utility of ccBOLD signal for resting-state analysis using conventional BOLD (cvBOLD) signal acquired without ASL modulations. To address this technical issue, resting cvBOLD and ASL perfusion MRI were acquired from a large cohort (n = 89) of healthy subjects. Four widely used resting-state brain function analyses were conducted and compared between the two types of BOLD signal, including the posterior cingulate cortex (PCC) seed-based functional connectivity (FC) analysis, independent component analysis (ICA), analysis of amplitude of low frequency fluctuation (ALFF), and analysis of regional homogeneity (ReHo). Consistent default mode network (DMN) as well as other resting-state networks (RSNs) were observed from cvBOLD and ccBOLD using PCC-FC analysis and ICA. ALFF from both modalities were the same for most of brain regions but were different in peripheral regions suffering from the susceptibility gradients induced signal drop. ReHo showed difference in many brain regions, likely reflecting the SNR and resolution differences between the two BOLD modalities. The DMN and auditory networks showed highest CBF values among all RSNs. These results demonstrated the feasibility of ASL perfusion MRI for assessing resting brain functions using its concurrent BOLD in addition to CBF signal, which provides a potentially useful way to maximize the utility of ASL perfusion MRI.  相似文献   

15.
《IRBM》2022,43(1):22-31
Epilepsy is a neurological disease from which a large number of younger and older people suffer all over the world. The status of the patients is primarily examined by using Electroencephalogram (EEG) signals. The most important part for successful surgery is to locate the epileptic seizure in the brain. For this reason, it is very useful to detect the seizure area automatically before surgery. In this research, a novel method based on continuous wavelet transform (CWT) and two-dimensional (2D) convolutional neural networks (CNNs) has been proposed to predict focal and non-focal epileptic seizure. The AlexNet, InceptionV3, Inception-ResNetV2, ResNet50 and VGG16 pre-trained models have been used to automatically classify 2D-scalogram images into focal and non-focal epileptic seizure. The performances of 5 pre-trained models were compared and the detection results of 2D-scalograms were examined. The best classification accuracy of 92.27% is yielded by the InceptionV3 model among the other used four pre-trained models. As a result, it may be said that the pre-trained models and 2D-scalogram images of focal and non-focal EEG signals will be useful to neurologists for rapid and robust prediction epileptic seizure before surgery.  相似文献   

16.
Mechanisms underlying seizure generation are traditionally thought to act over seconds to minutes before clinical seizure onset. We analyzed continuous 3- to 14-day intracranial EEG recordings from five patients with mesial temporal lobe epilepsy obtained during evaluation for epilepsy surgery. We found localized quantitative EEG changes identifying prolonged bursts of complex epileptiform discharges that became more prevalent 7 hr before seizures and highly localized subclinical seizure-like activity that became more frequent 2 hr prior to seizure onset. Accumulated energy increased in the 50 min before seizure onset, compared to baseline. These observations, from a small number of patients, suggest that epileptic seizures may begin as a cascade of electrophysiological events that evolve over hours and that quantitative measures of preseizure electrical activity could possibly be used to predict seizures far in advance of clinical onset.  相似文献   

17.
癫痫病人脑电信号的奇异谱   总被引:9,自引:1,他引:8  
癫痫是一种常见的神经系统疾患,其唯一客观证据为脑电图的癫痫样发放。在癫痫发作间期,仅有偶发的很难辨别的癫痫样放电,为了正确诊断癫痫病,往往需要医生长时间监测病人的脑电信号,在对脑电信号进行相空间重构,进而对其进行奇异系统分析,发现癫痫病人无论在癫痫发作前、发作中、发作后,其脑电信号的奇异谱曲线不存在噪声平台,明显区别于正常人。是否可以认为脑电信号的奇异谱正代表着大脑的一种基本状态,癫痫患者在未发作时,大脑的基本状态已经处于异常。无论如休,奇异系统分析方法使得可以利用很短的一段脑电数据诊断癫痫。无疑为癫痫病人的临床诊断提供了一条简单、有效的途径。  相似文献   

18.
This overview summarizes findings obtained from analyzing electroencephalographic (EEG) recordings from epilepsy patients with methods from the theory of nonlinear dynamical systems. The last two decades have shown that nonlinear time series analysis techniques allow an improved characterization of epileptic brain states and help to gain deeper insights into the spatial and temporal dynamics of the epileptic process. Nonlinear EEG analyses can help to improve the evaluation of patients prior to neurosurgery, and with an unequivocal identification of precursors of seizures, they can be of great value in the development of seizure warning and prevention techniques.  相似文献   

19.
癫痫发作的预测是近年来在临床医学和神经系统科学研究领域中备受关注的问题。如果癫痫发作能够被可靠地预测,则可以提前采取有效的临床预防措施,从而能较大程度地改善癫痫患者的生活质量。文章提出了一种基于二阶C0复杂度的预测算法用于预测癫痫发作。该算法通过分析癫痫患者颅内脑电信号的二阶C0复杂度,利用发作前期复杂度曲线的变化特征预测癫痫发作。作者运用该算法对21组癫痫病人87次发作的临床颅内脑电数据和4组大鼠4次发作的颅内脑电数据进行分析计算,预测准确率分别为94.3%和100%。实验结果表明该算法可以有效地预测癫痫发作,具有潜在的重要临床应用价值。  相似文献   

20.
Spontaneous seizures have been observed in several baboon species housed at the Southwest National Primate Research Center (SNPRC), including Papio hamadryas anubis and cynocephalus/anubis, hamadryas/anubis, and papio/anubis hybrids. The goal of this study was to establish a noninvasive, reliable electroencephalographic technique to characterize epilepsy phenotypes and assess photosensitivity in these subspecies. Thirty baboons with witnessed seizures, and 15 asymptomatic baboons underwent scalp electroencephalograms (EEGs) with photic stimulation (PS). The sensitivity and specificity of surface EEG for identifying interictal epileptic discharges (IEDs) in baboons with witnessed seizures were examined. The morphology of IEDs, electroclinical features of seizures and responses to PS, reproducibility of EEG findings, and intrarater reliability were also evaluated. Twenty-three seizure baboons (77%) demonstrated IEDs, predominantly with frequencies of 4-6 Hz in 18 baboons and 2-3 Hz in six baboons. Two seizure animals had a mixture of 2-3-Hz and 4-6-Hz IEDs. All animals with 2-3-Hz IEDs were 3 years old or younger. Myoclonic seizures (MS) and generalized tonic-clonic seizures (GTCS) were recorded in 13 baboons (43%). PS activated IEDs in 15 baboons (50%) and seizures in nine baboons. The presence of IEDs or seizures was not associated with a particular gender or species (Fisher exact test, alpha=0.05). Seizures were more common in animals >3 years old, while PS-induced IEDs and seizures were more prevalent in P.h. anubis/cynocephalus crosses compared to P.h. anubis. In the asymptomatic controls, IEDs were recorded in five baboons (33%), and photoparoxysmal responses were observed in two (13%). Surface EEG is a sensitive and reliable instrument for characterizing the epilepsy encountered in Papio species. Electroclinically, the seizure animals had generalized epilepsy with photosensitivity. The variation in IED morphology may be age-related or it may reflect different epileptic phenotypes. Ketamine provoked IEDs and seizures in most seizure animals and only in a few asymptomatic baboons; therefore, it may enhance the sensitivity of surface EEG for detecting a predisposition to epilepsy.  相似文献   

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