Monitoring time of interictal epileptiform discharges by long-term video EEG in patients with epilepsy / 浙江大学学报·医学版

To optimize the monitoring time of interictal epileptiform discharges (IED) in patients with epilepsy by long-term video electroencephalogram (VEEG).The cumulative percentages of IED detected by VEEG in 346 epilepsy patients (349 times) with different purposes, different waking sleep states and different MRI findings were retrospectively analyzed. According to the purposes, there were 164 patients (165 times) for clarifying diagnosis, 124 patients (124 times) for preoperative evaluation and 58 patients (60 times) for adjustment of medications. According to MRI results, there were responsible lesions in 98 patients (98 times) and no responsible lesions in 173 patients (174 times).Among 346 patients (349 times), IED was detected within 24 h in 231 patients (times). The percentage of detection in patients with purpose of preoperative evaluation was higher than those with purpose of diagnosis and medication adjustment. The detection of LED was gradually increased in first 8 h with 59.0%, then stably in 24 h. 46.8% IED was recorded during sleep time, particularly in the second stage of sleep. The cumulative percentage of IED in patients with abnormal MRI findings was higher in all periods. It reached 83.7% within 8 h, and then tended to be stable.The study shows that LED should be monitored by VEEG at least 8 hours and should include the second stage of sleep in patients with epilepsy. Patients with refractory epilepsy and with abnormal lesions on MRI should record IED more frequently.

Video electroencephalogram in occipital lobe epilepsy / 中华神经医学杂志

Objective To investigate the characteristics of video electroencephalogram (VEEG) in patients with occipital lobe epilepsy (OLE) to improve the clinical diagnostic rate of OLE.Methods Twenty-five patients with OLE were collected in our hospital from June 2013 to February 2017 and received VEEG monitoring in our epilepsy center.Their clinical symptoms and VEEG characteristics were retrospectively analyzed.Results Nineteen patients (76.00％) had visual auras based on previous history,five (38.46％) had visual auras during VEEG monitoring.Three patients had epileptic discharge confined to occipital lobe and two had epileptic discharge confined to posterior temporal lobe in interictal phase,while 20 had epileptic discharge involved more than one lobe of the brain.In ictal phase,8 had clear discharge origin or earliest evolution in occipital lobe.Five showed abnormal EEG in the other brain areas,which needed other clinical information for diagnosing OLE.Conclusions The visual aura is typical characteristic of OLE,and there are specific manifestations of EEG in both inter-ictal phase and ictal phase.

Postictal language testing in patients with temporal lobe epilepsy: a preliminary study / 中华神经科杂志

Objective Postictal language testing can provide useful diagnostic information for seizure lateralization.However no such a study based on non-English language was done previously.We investigated the latency of language recovery in Chinese patients with temporal lobe epilepsy (TLE).Methods Complex partial seizures in patients with TLE were extracted from our video-electroencephalogram (EEG) database.For all patients,consciousness testing started as soon as seizures were detected.When they were alert and cooperative,they were asked to read out a sentence “昨晚他们听到老在电台里讲话”which was printed on a card.When the patients were able to read the sentence correctly,the language function was considered recovered.Results Totally 65 complex partial seizures from 22 cases of TLE (11 left and 11 right) were included.Patients were cooperative to language testing in 54 seizures (83％).The latency for consciousness recovery (CRL) and latency for consciousness language recovery (LRL) were not associated with seizure duration,but the seizure lateralization.The CRL (median,161 s) and LRL (281 s) in the left TLE were statistically significantly longer than that in the right TLE (30 s,54 s respectively).Using 150 s recovery time as bound language recovery ratio was 87％ (27/31) in right TLE and 13％ (3/23) in left TLE.Conclusion Postictal language testing based on ideographic Chinese words helps to establish seizure lateralization in patients with TLE.

Quantitative EEG and event-related potentials (P300) in partial epilepsy / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>Quantitative EEG and event-related potential P300 were used to evaluate impairment of cerebral function in patient with partial epilepsy.</p><p><b>METHODS</b>W value was calculated (power of EEG δ and θ rhythm divided by power of α and β rhythm ) for the extent of focal cortical dysfunction. The W values in left partial epilepsy group, right partial epilepsy group and control group during interictal period compared. The latency, amplitude and reaction time of P300 potential change were observed in each groups.</p><p><b>RESULTS</b>The W values in F(8), T(4) and T(6) regions in patients with left partial epilepsy (P <0.05). The W values in T(3). O(1) regions of patients with left partial epilepsy were higher than those in patients with right partial epilepsy (P < 0.05). Furthermore, the W value in T(6) regions of patients with a disease course longer than 5y was significantly higher than that of patients with a disease course 1-5 y or less than 1y; the W value in O(2) regions of patients with a disease course longer than 5y was significantly higher than that of patients with a disease course between 1-5y (P < 0.05). In patients with right or left partial epilepsy, the total abnormal rate of P300 was 54. 76%, the latency, amplitude and reaction team were significantly different to the control group. The abnormal rate of P300 in left and right partial epilepsy groups were 77. 78% and 37.50%, respectively, and the former is significantly higher than the latter. The amplitudes of P300 in C(z) and P(z) of left partial epilepsy were significantly lower than those of right partial epilepsy and control group (P < 0.05). The latency and reaction time of P300 in C(z) and P(z) of all partial epilepsy were significantly longer than those of control group (P < 0.05), however, no difference was found between left and right partial epilepsy.</p><p><b>CONCLUSION</b>In partial epilepsy the cortical dysfunction occurs ipsilaterally to the epileptogenic zone, and extent of cortical dysfunction is positively correlated with duration of disease course. Cerebral dysfunction in left partial epilepsy is more severe than that in right partial epilepsy.</p>