OBJECTIVE The objective of the study was to examine the frequency and characteristics of ictal central apnea (ICA) in a selective cohort of patients with mesial or neocortical temporal lobe epilepsy (TLE) undergoing surface video-electroencephalography (EEG) and multimodal recording of cardiorespiratory parameters. METHODS We retrospectively screened 453 patients who underwent EEG in a single center including nasal airflow measurements, respiratory inductance plethysmography of thoracoabdominal excursions, peripheral capillary oxygen saturation, and electrocardiography. Patients with confirmed TLE subtype, either by magnetic resonance imaging (MRI) lesions limited to the temporal neocortex or mesial structures and concordant neurophysiologic data, or patients who underwent invasive explorations were included. RESULTS Ictal central apnea frequency and characteristics were analyzed in 41 patients with 164 seizures that had multimodal respiratory monitoring. The total occurrence of ICA in all seizures in this cohort was 79.9%. No significant difference was seen between mesial and neocortical temporal lobe seizures (79.8% and 80.0%, respectively). Ictal central apnea preceded EEG onset by 13 ± 11 s in 33.3% of seizures and was the first clinical sign by 18 ± 14 s in 48.7%. Longer ICA duration trended towards a more severe degree of hypoxemia. CONCLUSIONS In a selective cohort of TLE defined by MRI lesion and/or intracranial recordings, the frequency of ICA was higher than previously reported in the literature. Multimodal respiratory monitoring has localizing value and is generally well tolerated. Ictal central apnea preceded both EEG on scalp recordings as well as clinical seizure onset in a substantial number of patients. Respiratory monitoring and ICA detection is even more paramount during invasive monitoring to confirm that the recorded seizure onset is seen before the first clinical sign.

中文翻译：

---

颞叶癫痫发作期中枢性呼吸暂停

目的 本研究的目的是在接受表面视频脑电图 (EEG) 和心肺参数多模式记录的近中或新皮质颞叶癫痫 (TLE) 患者的选择性队列中检查发作中枢性呼吸暂停 (ICA) 的频率和特征. 方法 我们回顾性筛选了 453 名在单中心接受 EEG 的患者，包括鼻气流测量、胸腹偏移的呼吸电感体积描记、外周毛细血管血氧饱和度和心电图。包括通过仅限于颞叶新皮质或内侧结构的磁共振成像 (MRI) 病变和一致的神经生理学数据证实的 TLE 亚型的患者，或接受侵入性探查的患者。结果 分析了 41 名具有多模式呼吸监测的 164 次癫痫发作的患者的发作性中枢性呼吸暂停频率和特征。该队列所有癫痫发作中 ICA 的总发生率为 79.9%。内侧和新皮质颞叶癫痫发作之间没有显着差异（分别为 79.8% 和 80.0%）。在 33.3% 的癫痫发作中，发作性中枢性呼吸暂停先于 EEG 发作 13 ± 11 秒，并且在 48.7% 的 18 ± 14 秒内是第一个临床症状。更长的 ICA 持续时间趋向于更严重程度的低氧血症。结论 在由 MRI 病变和/或颅内记录定义的选择性 TLE 队列中，ICA 的频率高于之前文献中报道的频率。多模式呼吸监测具有定位价值，通常耐受性良好。在大量患者中，发作性中枢性呼吸暂停先于头皮记录的脑电图以及临床癫痫发作。在有创监测期间，呼吸监测和 ICA 检测更为重要，以确认记录的癫痫发作发生在第一个临床症状之前。