局灶性皮质发育不良和神经发育肿瘤的癫痫发作模式与手术预后和神经病理亚型的联系_Journal of Epilepsy

Authors：

StanislasLagarde , FrancescaBonini , AileenMcGonigal , PatrickChauvel , MartineGavaret , DidierScavarda , RomainCarron , JeanRegis , SandrineAubert , NathalieVilleneuve , BernardGiusiano , DominiqueFigarella-Branger , AgnesTrebuchon ,  FabriceBartolomei , 张颖颖 , 慕洁

Corresponding author：

FabriceBartolomei, Email: fabrice.bartolomei@ap-hm.fr

Keywords：

癫痫; 局灶性皮质发育不良; 神经发育肿瘤; 皮质发育畸形; 立体定向脑电图; 癫痫发作; 癫痫手术; 癫痫灶

DOI：

10.7507/2096-0247.20170024

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

颅内脑电图对癫痫发作模式的研究对癫痫灶的精确定位和指导成功切除有重要作用。它也引出了癫痫发生机制相关的重要病理生理问题。目前，植入硬膜下和深部电极等记录方式已经描述了几种癫痫发作模式 (主要是颞叶癫痫和伴有异质新皮层病变的癫痫)。研究分析了53例患者的连续性队列资料，所有患者均行立体定向脑电图 (SEEG) 监测，且病理证实为皮质发育畸形 (Malformation of cortical development, MCD)——局灶性皮质发育不良 (Focal cortical dysplasia, FCD) 和神经发育肿瘤 (Neurodevelopmental tumors, NDTs)。通过对视觉和时间-频率的分析，证实了存在6种癫痫发作模式：低压快波活动 (Low-voltage fast activity, LVFA)；发作前棘波继之LVFA；爆发性多棘波继之LVFA；慢波/直流电漂移继之LVFA；θ或α尖波；节律性棘波/棘波。结果表明包含LVFA的模式 (83%) 普遍性较高，但是LVFA并不是癫痫发作的一个固定特征。癫痫发作模式和组织学类型具有相关性 (P=0.01)。更加普遍的模式如下：① FCD Ⅰ型：LVFA占23.1%，慢波/基线漂移继之LVFA占15.4%；② FCD Ⅱ型：爆发性多棘波继之LVFA占31%，LVFA占27.6%；发作前棘波继之LVFA占27.6%；③ NDTs：LVFA占54.5%。发现包含LVFA的癫痫发作模式与较好的手术预后具有相关性，但癫痫灶切除的完整性是一个独立预测因子；FCD和NDTs有6种不同的癫痫发作模式；包含LVFA的癫痫发作模式的患者手术预后更好。

Citation： StanislasLagarde, FrancescaBonini, AileenMcGonigal, PatrickChauvel, MartineGavaret, DidierScavarda, RomainCarron, JeanRegis, SandrineAubert, NathalieVilleneuve, BernardGiusiano, DominiqueFigarella-Branger, AgnesTrebuchon, FabriceBartolomei, 张颖颖, 慕洁. 局灶性皮质发育不良和神经发育肿瘤的癫痫发作模式与手术预后和神经病理亚型的联系. Journal of Epilepsy, 2017, 3(2): 158-166. doi: 10.7507/2096-0247.20170024 Copy

1.	Guerrini R, Dobyns WB. Malformations of cortical development: clinical features and genetic causes. Lancet Neurol, 2014, 13(6): 710-726.
2.	Palmini A. Revising the classification of focal cortical dysplasias. Epilepsia, 2011, 52(1): 188-190.
3.	Honavar M, Janota I, Polkey CE. Histological heterogeneity of dysembryoplastic neuroepithelial tumour: identification and differential diagnosis in a series of 74 cases. Histopathology, 1999, 34(2): 342-356.
4.	Chassoux F, Landre E, Mellerio C, et al. Dysembryoplastic neuroepithelial tumors: epileptogenicity related to histologic subtypes. Clin Neurophysiol, 2013, 124(11): 1068-1078.
5.	Krsek P, Maton B, Jayakar P, et al. Incomplete resection of focal cortical dysplasia is the main predictor of poor postsurgical outcome. Neurology, 2009, 72(4): 217-223.
6.	Blumcke I, Thom M, Aronica E, et al. The clinicopathologic spectrum of focal cortical dysplasias: a consensus classification proposed by an ad hoc Task Force of the ILAE Diagnostic Methods Commission. Epilepsia, 2011, 52(3): 158-174.
7.	Guerrini R, Duchowny M, Jayakar P, et al. Diagnostic methods and treatment options for focal cortical dysplasia. Epilepsia, 2015, 56(3): 1669-1686.
8.	Englot DJ, Berger MS, Barbaro NM, et al. Factors associated with seizure freedom in the surgical resection of glioneuronal tumors. Epilepsia, 2012, 53(7): 51-57.
9.	Daumas-Duport C. Dysembryoplastic neuroepithelial tumours. Brain Pathol, 1993, 3(2): 283-295.
10.	Louis DN, Ohgaki H, Wiestler OD, et al. The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol, 2007, 114(10): 97-109.
11.	Thom M, Blumcke I, Aronica E. Long-term epilepsy-associated tumors. Brain Pathol, 2012, 22(5): 350-379.
12.	Rowland NC, Englot DJ, Cage TA, et al. A meta-analysis of predictors of seizure freedom in the surgical management of focal cortical dysplasia. J Neurosurg, 2012, 116(7): 1035-1041.
13.	Francione S, Nobili L, Cardinale F, et al. Intra-lesional stereo-EEG activity in Taylor′s focal cortical dysplasia. Epileptic Disord, 2003, 5 (Suppl 2): 105-114.
14.	Chassoux F, Devaux B, Landre E, et al. Stereoelectroencephalography in focal cortical dysplasia: a 3D approach to delineating the dysplastic cortex. Brain, 2000, 123(Pt 8): 1733-1751.
15.	Aubert S, Wendling F, Regis J, et al. Local and remote epileptogenicity in focal cortical dysplasias and neurodevelopmental tumours. Brain, 2009, 132(Pt6): 3072-3086.
16.	Holtkamp M, Sharan A, Sperling MR. Intracranial EEG in predicting surgical outcome in frontal lobe epilepsy. Epilepsia, 2012, 53(4): 1739-1745.
17.	Jimenez-Jimenez D, Nekkare R, Flores L, et al. Prognostic value of intracranial seizure onset patterns for surgical outcome of the treatment of epilepsy. Clin Neurophysiol, 2015, 126(3): 257-267.
18.	Kutsy RL, Farrell DF, Ojemann GA. Ictal patterns of neocortical seizures monitored with intracranial electrodes: correlation with surgical outcome. Epilepsia, 1999, 40(2): 257-266.
19.	Mathern GW, Babb TL, Pretorius JK, et al. The pathophysiologic relationships between lesion pathology, intracranial ictal EEG onsets, and hippocampal neuron losses in temporal lobe epilepsy. Epilepsy Res, 1995, 21(11): 133-147.
20.	Ogren JA, Bragin A, Wilson CL, et al. Three-dimensional hippocampal atrophy maps distinguish two common temporal lobe seizure-onset patterns. Epilepsia, 2009, 50(9): 1361-1370.
21.	Wennberg R, Arruda F, Quesney LF, et al. Preeminence of extrahippocampal structures in the generation of mesial temporal seizures: evidence from human depth electrode recordings. Epilepsia, 2002, 43(5): 716-726.
22.	Spencer SS, Guimaraes P, Katz A, et al. Morphological patterns of seizures recorded intracranially. Epilepsia, 1992, 33(2): 537-545.
23.	Townsend JB, Engel JJr. Clinicopathological correlations of low voltage fast and high amplitude spike and wave mesial temporal stereoencephalographic ictal onsets. Epilepsia, 1991, 32(7): 21.
24.	Velasco AL, Wilson CL, Babb TL, et al. Functional and anatomic correlates of two frequently observed temporal lobe seizure-onset patterns. Neural Plast, 2000, 7(1): 49-63.
25.	Lee SA, Spencer DD, Spencer SS. Intracranial EEG seizure-onset patterns in neocortical epilepsy. Epilepsia, 2000, 41(10): 297-307.
26.	Wetjen NM, Marsh WR, Meyer FB, et al. Intracranial electroencephalography seizure onset patterns and surgical outcomes in nonlesional extratemporal epilepsy. J Neurosurg, 2009, 110(7): 1147-1152.
27.	Perucca P, Dubeau F, Gotman J. Intracranial electroencephalographic seizure-onset patterns: effect of underlying pathology. Brain, 2014, 137(9): 183-196.
28.	Bartolomei F, Chauvel P, Wendling F. Epileptogenicity of brain structures in human temporal lobe epilepsy: a quantified study from intracerebral EEG. Brain, 2008, 131(4): 1818-1830.
29.	Engel J. Update on surgical treatment of the epilepsies. Summary of the second international palm desert conference on the surgical treatment of the epilepsies (1992). Neurology, 1993, 43(3): 1612-1617.
30.	Singh S, Sandy S, Wiebe S. Ictal onset on intracranial EEG: do we know it when we see it? State of the evidence. Epilepsia, 2015, 56(11): 1629-1638.
31.	Ikeda A, Terada K, Mikuni N, et al. Subdural recording of ictal DC shifts in neocortical seizures in humans. Epilepsia, 1996, 37(7): 662-674.
32.	Bragin A, Claeys P, Vonck K, et al. Analysis of initial slow waves (ISWs) at the seizure onset in patients with drug resistant temporal lobe epilepsy. Epilepsia, 2007, 48(6): 1883-1894.
33.	Jirsa VK, Stacey WC, Quilichini PP, et al. On the nature of seizure dynamics. Brain, 2014, 137(7): 2210-2230.
34.	Pitkanen A, Lukasiuk K. Mechanisms of epileptogenesis and potential treatment targets. Lancet Neurol, 2011, 10(9): 173-186.
35.	Tassi L, Colombo N, Garbelli R, et al. Focal cortical dysplasia: neuropathological subtypes, EEG, neuroimaging and surgical outcome. Brain, 2002, 125(12): 1719-1732.
36.	Faught E, Kuzniecky RI, Hurst DC. Ictal EEG wave forms from epidural electrodes predictive of seizure control after temporal lobectomy. Electroencephalogr Clin Neurophysiol, 1992, 83(10): 229-235.
37.	Bragin A, Azizyan A, Almajano J, et al. The cause of the imbalance in the neuronal network leading to seizure activity can be predicted by the electrographic pattern of the seizure onset. J Neurosci, 2009, 29(11): 3660-3671.
38.	Jung WY, Pacia SV, Devinsky R. Neocortical temporal lobe epilepsy: intracranial EEG features and surgical outcome. J Clin Neurophysiol, 1999, 16(3): 419-425.
39.	Kim DW, Kim HK, Lee SK, et al. Extent of neocortical resection and surgical outcome of epilepsy: intracranial EEG analysis. Epilepsia, 2010, 51(2): 1010-1017.
40.	Spanedda F, Cendes F, Gotman J. Relations between EEG seizure morphology, interhemispheric spread, and mesial temporal atrophy in bitemporal epilepsy. Epilepsia, 1997, 38(2): 1300-1314.

1. Guerrini R, Dobyns WB. Malformations of cortical development: clinical features and genetic causes. Lancet Neurol, 2014, 13(6): 710-726.
2. Palmini A. Revising the classification of focal cortical dysplasias. Epilepsia, 2011, 52(1): 188-190.
3. Honavar M, Janota I, Polkey CE. Histological heterogeneity of dysembryoplastic neuroepithelial tumour: identification and differential diagnosis in a series of 74 cases. Histopathology, 1999, 34(2): 342-356.
4. Chassoux F, Landre E, Mellerio C, et al. Dysembryoplastic neuroepithelial tumors: epileptogenicity related to histologic subtypes. Clin Neurophysiol, 2013, 124(11): 1068-1078.
5. Krsek P, Maton B, Jayakar P, et al. Incomplete resection of focal cortical dysplasia is the main predictor of poor postsurgical outcome. Neurology, 2009, 72(4): 217-223.
6. Blumcke I, Thom M, Aronica E, et al. The clinicopathologic spectrum of focal cortical dysplasias: a consensus classification proposed by an ad hoc Task Force of the ILAE Diagnostic Methods Commission. Epilepsia, 2011, 52(3): 158-174.
7. Guerrini R, Duchowny M, Jayakar P, et al. Diagnostic methods and treatment options for focal cortical dysplasia. Epilepsia, 2015, 56(3): 1669-1686.
8. Englot DJ, Berger MS, Barbaro NM, et al. Factors associated with seizure freedom in the surgical resection of glioneuronal tumors. Epilepsia, 2012, 53(7): 51-57.
9. Daumas-Duport C. Dysembryoplastic neuroepithelial tumours. Brain Pathol, 1993, 3(2): 283-295.
10. Louis DN, Ohgaki H, Wiestler OD, et al. The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol, 2007, 114(10): 97-109.
11. Thom M, Blumcke I, Aronica E. Long-term epilepsy-associated tumors. Brain Pathol, 2012, 22(5): 350-379.
12. Rowland NC, Englot DJ, Cage TA, et al. A meta-analysis of predictors of seizure freedom in the surgical management of focal cortical dysplasia. J Neurosurg, 2012, 116(7): 1035-1041.
13. Francione S, Nobili L, Cardinale F, et al. Intra-lesional stereo-EEG activity in Taylor′s focal cortical dysplasia. Epileptic Disord, 2003, 5 (Suppl 2): 105-114.
14. Chassoux F, Devaux B, Landre E, et al. Stereoelectroencephalography in focal cortical dysplasia: a 3D approach to delineating the dysplastic cortex. Brain, 2000, 123(Pt 8): 1733-1751.
15. Aubert S, Wendling F, Regis J, et al. Local and remote epileptogenicity in focal cortical dysplasias and neurodevelopmental tumours. Brain, 2009, 132(Pt6): 3072-3086.
16. Holtkamp M, Sharan A, Sperling MR. Intracranial EEG in predicting surgical outcome in frontal lobe epilepsy. Epilepsia, 2012, 53(4): 1739-1745.
17. Jimenez-Jimenez D, Nekkare R, Flores L, et al. Prognostic value of intracranial seizure onset patterns for surgical outcome of the treatment of epilepsy. Clin Neurophysiol, 2015, 126(3): 257-267.
18. Kutsy RL, Farrell DF, Ojemann GA. Ictal patterns of neocortical seizures monitored with intracranial electrodes: correlation with surgical outcome. Epilepsia, 1999, 40(2): 257-266.
19. Mathern GW, Babb TL, Pretorius JK, et al. The pathophysiologic relationships between lesion pathology, intracranial ictal EEG onsets, and hippocampal neuron losses in temporal lobe epilepsy. Epilepsy Res, 1995, 21(11): 133-147.
20. Ogren JA, Bragin A, Wilson CL, et al. Three-dimensional hippocampal atrophy maps distinguish two common temporal lobe seizure-onset patterns. Epilepsia, 2009, 50(9): 1361-1370.
21. Wennberg R, Arruda F, Quesney LF, et al. Preeminence of extrahippocampal structures in the generation of mesial temporal seizures: evidence from human depth electrode recordings. Epilepsia, 2002, 43(5): 716-726.
22. Spencer SS, Guimaraes P, Katz A, et al. Morphological patterns of seizures recorded intracranially. Epilepsia, 1992, 33(2): 537-545.
23. Townsend JB, Engel JJr. Clinicopathological correlations of low voltage fast and high amplitude spike and wave mesial temporal stereoencephalographic ictal onsets. Epilepsia, 1991, 32(7): 21.
24. Velasco AL, Wilson CL, Babb TL, et al. Functional and anatomic correlates of two frequently observed temporal lobe seizure-onset patterns. Neural Plast, 2000, 7(1): 49-63.
25. Lee SA, Spencer DD, Spencer SS. Intracranial EEG seizure-onset patterns in neocortical epilepsy. Epilepsia, 2000, 41(10): 297-307.
26. Wetjen NM, Marsh WR, Meyer FB, et al. Intracranial electroencephalography seizure onset patterns and surgical outcomes in nonlesional extratemporal epilepsy. J Neurosurg, 2009, 110(7): 1147-1152.
27. Perucca P, Dubeau F, Gotman J. Intracranial electroencephalographic seizure-onset patterns: effect of underlying pathology. Brain, 2014, 137(9): 183-196.
28. Bartolomei F, Chauvel P, Wendling F. Epileptogenicity of brain structures in human temporal lobe epilepsy: a quantified study from intracerebral EEG. Brain, 2008, 131(4): 1818-1830.
29. Engel J. Update on surgical treatment of the epilepsies. Summary of the second international palm desert conference on the surgical treatment of the epilepsies (1992). Neurology, 1993, 43(3): 1612-1617.
30. Singh S, Sandy S, Wiebe S. Ictal onset on intracranial EEG: do we know it when we see it? State of the evidence. Epilepsia, 2015, 56(11): 1629-1638.
31. Ikeda A, Terada K, Mikuni N, et al. Subdural recording of ictal DC shifts in neocortical seizures in humans. Epilepsia, 1996, 37(7): 662-674.
32. Bragin A, Claeys P, Vonck K, et al. Analysis of initial slow waves (ISWs) at the seizure onset in patients with drug resistant temporal lobe epilepsy. Epilepsia, 2007, 48(6): 1883-1894.
33. Jirsa VK, Stacey WC, Quilichini PP, et al. On the nature of seizure dynamics. Brain, 2014, 137(7): 2210-2230.
34. Pitkanen A, Lukasiuk K. Mechanisms of epileptogenesis and potential treatment targets. Lancet Neurol, 2011, 10(9): 173-186.
35. Tassi L, Colombo N, Garbelli R, et al. Focal cortical dysplasia: neuropathological subtypes, EEG, neuroimaging and surgical outcome. Brain, 2002, 125(12): 1719-1732.
36. Faught E, Kuzniecky RI, Hurst DC. Ictal EEG wave forms from epidural electrodes predictive of seizure control after temporal lobectomy. Electroencephalogr Clin Neurophysiol, 1992, 83(10): 229-235.
37. Bragin A, Azizyan A, Almajano J, et al. The cause of the imbalance in the neuronal network leading to seizure activity can be predicted by the electrographic pattern of the seizure onset. J Neurosci, 2009, 29(11): 3660-3671.
38. Jung WY, Pacia SV, Devinsky R. Neocortical temporal lobe epilepsy: intracranial EEG features and surgical outcome. J Clin Neurophysiol, 1999, 16(3): 419-425.
39. Kim DW, Kim HK, Lee SK, et al. Extent of neocortical resection and surgical outcome of epilepsy: intracranial EEG analysis. Epilepsia, 2010, 51(2): 1010-1017.
40. Spanedda F, Cendes F, Gotman J. Relations between EEG seizure morphology, interhemispheric spread, and mesial temporal atrophy in bitemporal epilepsy. Epilepsia, 1997, 38(2): 1300-1314.

Previous Article
儿童症状性局灶性癫痫和可疑症状性局灶性癫痫：一个观察性的前瞻性多中心研究
Next Article
成人癫痫监测单元的质量和安全性：系统评价和Meta分析

Journal of Epilepsy

局灶性皮质发育不良和神经发育肿瘤的癫痫发作模式与手术预后和神经病理亚型的联系

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content