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首页> 外文期刊>Clinical EEG and neuroscience: official journal of the EEG and Clinical Neuroscience Society (ENCS) >Spikes and epilepsy.
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Spikes and epilepsy.

机译：尖刺和癫痫病。

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Digital EEG analysis provides significantly more information to the clinical electroencephalographer (EEGer) for scalp as well as for intracranial monitoring than is currently being routinely utilized. When modern data analysis software is used, interictal spikes contain considerably more information than had previously been ascribed to them. To optimize the diagnostic value of the EEG, sleep recordings after sleep deprivation is valuable because focal spikes, unless abundant, are relatively rare in the waking state. Recording time should also be sufficiently long to allow spikes to emerge. Spikes are always pathologic and can be associated with impaired cerebral perfusion, metabolic changes and concomitant behavioral changes. They can also be separated into simple and complex forms which may allow prognostic statements. The simplest way to accomplish this is by placing a cursor on the peak of the spike and see whether or not other channels show latency differences. More precise methods are: comparisons of voltage maps with current source density maps, principal component analysis and distinctions between stationary versus moving dipoles. Averaging of spikes is valuable but care must be taken that only those spikes which have the same distribution are averaged, and when the average is obtained only from the spike peak, propagation may already have occurred. It has been recommended that the midpoint of the ascending negative phase be used as the point for averaging. In intracranial recordings the frequencies above the gamma range should also be assessed. Their small electrical field allows a differentiation between locally generated events from those which are volume conducted and can thereby more accurately reflect the epileptogenic zone(s). High frequency activity can also be recorded from foramen ovale electrodes which enhances their diagnostic utility. It is emphasized that for centers which perform pre-surgical evaluations the software supplied by instrument manufacturers is inadequate and needs to be supplemented by additional commercially available programs. Furthermore, archived data should be used for retrospective investigations and follow-up studies of patients who have undergone either excisions, resections, or multiple subpial transections to evaluate the success rates by taking into account all the properties of interictal and ictal recordings which are mentioned in this article.
机译：与目前常规使用的相比，数字EEG分析为临床脑电图师（EEGer）提供了有关头皮以及颅内监测的大量信息。当使用现代数据分析软件时，尖峰包含的信息比以前归因于它们的信息要多得多。为了优化脑电图的诊断价值，剥夺睡眠后的睡眠记录很有价值，因为除非在清醒状态下局部峰值很少，否则峰值很少。记录时间也应足够长，以使尖峰出现。尖峰总是病理性的，并可能与脑灌注受损，代谢变化和伴随的行为变化有关。它们也可以分为简单形式和复杂形式，这些形式可以进行预后判断。实现此目的的最简单方法是将光标放在尖峰的峰值上，然后查看其他通道是否显示延迟差异。更精确的方法是：将电压图与电流源密度图进行比较，主成分分析以及固定偶极子与移动偶极子之间的区别。尖峰的平均很有价值，但是必须注意，只有那些具有相同分布的尖峰才被平均，并且当仅从尖峰获得平均值时，可能已经发生了传播。建议将上升的负相位的中点用作平均点。在颅内记录中，也应评估高于伽马范围的频率。它们的小电场使局部产生的事件与体积传导的事件之间有所区别，从而可以更准确地反映出癫痫发作区。还可以从卵圆孔电极记录高频活动，从而增强其诊断效用。需要强调的是，对于进行手术前评估的中心，器械制造商提供的软件不足，需要通过其他可商购的程序进行补充。此外，存档的数据应用于回顾性研究和对已行切除，切除或多次pi下横断的患者的随访研究，以通过考虑到在文献中提到的耳蜗和耳蜗记录的所有特性来评估成功率。本文。

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