SEEG seizure onset patterns in mesial temporal lobe epilepsy: A cohort study with 76 patients

IF 2.7 4区医学 Q2 CLINICAL NEUROLOGY

Neurophysiologie Clinique/Clinical Neurophysiology Pub Date : 2025-01-01 DOI:10.1016/j.neucli.2024.103040

Du Cai , Xiu Wang , Wenhan Hu , Jiajie Mo , Baotian Zhao , Zhong Zheng , Lin Sang , Xiaoqiu Shao , Chao Zhang , Jianguo Zhang , Kai Zhang

{"title":"SEEG seizure onset patterns in mesial temporal lobe epilepsy: A cohort study with 76 patients","authors":"Du Cai , Xiu Wang , Wenhan Hu , Jiajie Mo , Baotian Zhao , Zhong Zheng , Lin Sang , Xiaoqiu Shao , Chao Zhang , Jianguo Zhang , Kai Zhang","doi":"10.1016/j.neucli.2024.103040","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><div>In the present study with a large cohort, we aimed to characterize intracerebral seizure onset patterns (SOP) of mesial temporal lobe epilepsy (mTLE), with or without hippocampal sclerosis (HS) as identified via magnetic resonance imaging (MRI).</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 255 seizures of 76 consecutive patients with mTLE explored by stereoelectroencephalography (SEEG), including HS-mTLE (<em>n</em> = 52) and non-HS- mTLE (<em>n</em> = 24). Relevant results were obtained by a combination of spectral analysis and manual review. High-frequency oscillations (HFO) were quantified across different SOP by an automatic detection method.</div></div><div><h3>Results</h3><div>We identified six SOP according to previous work by Lagarde et al.: (1) Low-voltage fast activity (LVFA); (2) Rhythmic spikes followed by LVFA; (3) Burst of spikes followed by LVFA; (4) Periodic spikes or spike-wave followed by LVFA; (5) Rhythmic spike or spike-wave; (6) Theta or alpha sharp activity. Notably, Periodic spikes or spike-wave followed by LVFA had a high prevalence in all seizures (37 %). A significant association was established between Periodic spike followed by LVFA and HS-mTLE (<span><math><mi>P</mi></math></span> < 0.05). Furthermore, the counts of ripples and fast ripples were significantly higher in SOP displaying LVFA compared to those that did not (<em>P</em> < 0.05). Rhythmic spikes followed by LVFA had the best prognosis (92 % seizure-free), while Burst of spikes followed by LVFA were linked to poorest prognosis (67 % SF).</div></div><div><h3>Conclusion</h3><div>HS-mTLE and non-HS-mTLE exhibit distinct SOP characteristics, which can offer valuable prognostic insights with a more informative interpretation of ictal iEEG for clinical guidance.</div></div>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"55 1","pages":"Article 103040"},"PeriodicalIF":2.7000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neurophysiologie Clinique/Clinical Neurophysiology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0987705324000984","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objectives

In the present study with a large cohort, we aimed to characterize intracerebral seizure onset patterns (SOP) of mesial temporal lobe epilepsy (mTLE), with or without hippocampal sclerosis (HS) as identified via magnetic resonance imaging (MRI).

Methods

We retrospectively analyzed 255 seizures of 76 consecutive patients with mTLE explored by stereoelectroencephalography (SEEG), including HS-mTLE (n = 52) and non-HS- mTLE (n = 24). Relevant results were obtained by a combination of spectral analysis and manual review. High-frequency oscillations (HFO) were quantified across different SOP by an automatic detection method.

Results

We identified six SOP according to previous work by Lagarde et al.: (1) Low-voltage fast activity (LVFA); (2) Rhythmic spikes followed by LVFA; (3) Burst of spikes followed by LVFA; (4) Periodic spikes or spike-wave followed by LVFA; (5) Rhythmic spike or spike-wave; (6) Theta or alpha sharp activity. Notably, Periodic spikes or spike-wave followed by LVFA had a high prevalence in all seizures (37 %). A significant association was established between Periodic spike followed by LVFA and HS-mTLE (

P

< 0.05). Furthermore, the counts of ripples and fast ripples were significantly higher in SOP displaying LVFA compared to those that did not (P < 0.05). Rhythmic spikes followed by LVFA had the best prognosis (92 % seizure-free), while Burst of spikes followed by LVFA were linked to poorest prognosis (67 % SF).

Conclusion

HS-mTLE and non-HS-mTLE exhibit distinct SOP characteristics, which can offer valuable prognostic insights with a more informative interpretation of ictal iEEG for clinical guidance.

查看原文本刊更多论文

内侧颞叶癫痫的SEEG发作模式：76例队列研究。

目的：在本研究中，我们旨在通过磁共振成像（MRI）确定伴有或不伴有海马硬化（HS）的中颞叶癫痫（mTLE）的脑内发作模式（SOP）。方法：回顾性分析76例经立体脑电图（SEEG）检查的mTLE患者255次癫痫发作，包括HS-mTLE （n = 52）和非HS-mTLE （n = 24）。将光谱分析与人工评审相结合，得到了相关结果。采用自动检测方法对不同SOP的高频振荡（HFO）进行量化。结果：根据Lagarde等人的工作，我们确定了6个SOP:(1)低压快速活性（LVFA）；(2)节奏尖峰后LVFA；(3)尖峰爆发，随后LVFA；(4)周期尖峰或尖峰波后LVFA；(5)有节奏的尖峰或尖峰波；(6) θ或α尖峰活动。值得注意的是，周期性尖峰或尖峰波之后LVFA在所有癫痫发作中都有很高的患病率（37%）。周期尖峰后LVFA与HS-mTLE有显著相关性（P < 0.05）。LVFA组的波纹数和快速波纹数显著高于对照组（P < 0.05）。节律性尖峰随后LVFA的预后最好（92%无癫痫发作），而爆发性尖峰随后LVFA的预后最差（67% SF）。结论：HS-mTLE和非HS-mTLE表现出不同的SOP特征，可以为临床指导提供更有价值的预后信息。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Neurophysiologie Clinique/Clinical Neurophysiology 医学-临床神经学

CiteScore

5.20

自引率

3.30%

发文量

审稿时长

60 days

期刊介绍： Neurophysiologie Clinique / Clinical Neurophysiology (NCCN) is the official organ of the French Society of Clinical Neurophysiology (SNCLF). This journal is published 6 times a year, and is aimed at an international readership, with articles written in English. These can take the form of original research papers, comprehensive review articles, viewpoints, short communications, technical notes, editorials or letters to the Editor. The theme is the neurophysiological investigation of central or peripheral nervous system or muscle in healthy humans or patients. The journal focuses on key areas of clinical neurophysiology: electro- or magneto-encephalography, evoked potentials of all modalities, electroneuromyography, sleep, pain, posture, balance, motor control, autonomic nervous system, cognition, invasive and non-invasive neuromodulation, signal processing, bio-engineering, functional imaging.