癫痫杂志

癫痫杂志

高频脑电振荡:临床研究综述

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现代脑电图(EEG)技术的进步增强了对经典伯杰频段外,包含重要信息的脑电信号的识别。在癫痫领域,近十年的相关研究主要集中在发作间期>80 Hz 的高频振荡(High frequency oscillations, HFOs)。HFOs 大型临床应用始于癫痫手术术前的评估,近来也开始用于评估癫痫严重程度和监测抗癫痫疗效。该综述总结了 HFOs 在癫痫临床应用的证据,重点介绍了最新的进展。近期大量文献强调了 HFOs 与术后癫痫预后关系,一篇近期的 Meta 分析证实术后癫痫未发作患者 HFOs 切除率高于术后发作患者,利用术后 EEG 中的残留 HFOs 比术前 HFOs 率对癫痫手术预后预测更准确。文章深入讨论了区分生理性和癫痫性 HFOs 的尝试,这可能进一步加强 HFOs 的特异度。如睡眠结构分析表明,在痫灶内外对 HFOs 的偶联有差异。同时,越来越多的证据表明,HFOs 可用于对评估疾病活动度和利用非侵入性 EEG 和脑磁图(MEG)等检查中评估治疗效果。鉴于儿童 EEG 中 HFOs 比例高,这一技术在患儿中有良好的前景。在婴儿痉挛症中经促肾上腺皮质激素治疗后 HFOs 比例下降。在Rolandic区棘波时出现 HFOs 与发作频率相关。耗时的人工评估是过去 HFOs 临床应用的障碍,目前这一问题可由可靠的计算机算法解决。过去十年,HFOs 研究有了长足进展,利用非侵入性手段检测 HFOs 已在大量患者中得到应用。期待未来有多中心、大样本量研究获取长程监测资料,为这一领域提供更多信息。

关键词: 头皮脑电图; 生物标记; 手术预后; 癫痫发作; 睡眠

引用本文: BirgitFrauscher, FabriceBartolomei, KatsuhiroKobayashi, 陆璐 译, 张乐 慕洁 审. 高频脑电振荡:临床研究综述. 癫痫杂志, 2018, 4(6): 545-557. doi: 10.7507/2096-0247.20180086 复制

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