Current-Source Dipole of Anterior Temporal Spikes: Clinical Significance of Orientation.
- Author:
Young Soo KIM
1
;
Oh Young KWON
;
Seokwon JUNG
;
Seungnam SON
;
SooKyung KIM
;
Heeyoung KANG
;
Ki Jong PARK
;
Nack Cheon CHOI
;
Byeong Hoon LIM
Author Information
1. Department of Neurologya, Gyeongsang National University School of Medicine, Jinju, Korea. mnkwon21@hanmail.net
- Publication Type:Original Article
- Keywords:
Electroencephalography;
Anterior temporal spikes;
Current-dipole source;
Temporal lobe epilepsy;
Aura;
Drug-resistant epilepsy
- MeSH:
Age of Onset;
Brain;
Drug Resistance;
Electroencephalography;
Epilepsy;
Epilepsy, Temporal Lobe;
Generalization (Psychology);
Humans;
Orientation;
Scalp;
Sclerosis;
Seizures;
Seizures, Febrile
- From:Journal of the Korean Neurological Association
2011;29(3):165-171
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: The voltage topography of temporal spikes has two distinct patterns, designated type I and type II; the orientation of the current-dipole source (O-CDS) of type I spikes tends to be oblique, while that of type II spikes tends to be horizontal. The purpose of this study was to identify the effects of the O-CDS of anterior temporal spikes on clinical factors including onset age, seizure frequency, secondary generalization, disease duration, intractability, polytherapy, febrile seizure, hippocampal sclerosis, and neocortical-temporal aura. METHODS: We examined the scalp electroencephalograms of 24 patients with temporal lobe epilepsy (TLE) and anterior temporal spikes. A spatiotemporal dipole model was applied to determine the O-CDS of the averaged spikes in each patient. We performed current-source analysis of multiple spatiotemporal dipole models using Brain Electrical Source Analysis software. The patients were divided into two subgroups according to their O-CDS pattern: oblique and horizontal. Clinical factors were compared between the two groups. RESULTS: Sixteen patients were classified into the oblique group, and 8 patients into the horizontal group. A neocortical-temporal aura was more commonly observed in the horizontal group (p<0.05), while drug-resistance tendencies were more commonly observed in the oblique group (p<0.1). CONCLUSIONS: The horizontal O-CDS of anterior temporal spikes may be more frequently associated with a neocortical-temporal aura than the oblique O-CDS in TLE. In addition, the oblique O-CDS pattern suggests a tendency toward drug resistance. The findings of this study imply that the oblique O-CDS pattern of anterior temporal spikes may provide additional electrophysiologic information regarding drug-resistant mesial TLE.
