OBJECTIVE Lateralized periodic discharges (LPDs), which constitute an abnormal electroencephalographic (EEG) pattern, are most often observed in critically ill patients with acute pathological conditions, and are less frequently observed in chronic conditions such as focal epilepsies, including temporal lobe epilepsy (TLE). Here we aim to explore the pathophysiological mechanism of LPD in TLE. METHODS We retrospectively selected 3 patients with drug-resistant TLE who simultaneously underwent EEG and electrocorticography (ECoG) and demonstrated LPDs. We analyzed the correlation between the EEG and ECoG findings. RESULTS In patients 1 and 2, LPDs were recorded in the temporal region of the scalp during the interictal periods, when repeated spikes followed by slow waves (spike-and-wave complexes; SWs) and periodic discharges (PDs) with amplitudes of >600 to 800 µV appeared in the lateral temporal lobe over a cortical area of >10 cm2. In patient 3, when the ictal discharges persisted and were confined to the medial temporal lobe, repeated SWs were provoked on the lateral temporal lobe. When repeated SWs with amplitudes of >800 µV appeared in an area of the lateral temporal lobe of >10 cm2, the corresponding EEG discharges appeared on the temporal scalp. CONCLUSIONS LPDs in patients with TLE originate from repeated SWs and PDs of the lateral temporal lobe, which might represent a highly irritable state of the lateral temporal cortex during both interictal and ictal periods.

中文翻译：

---

颞叶癫痫侧向周期性放电的同步脑电图和皮层电图记录

目的 侧向周期性放电 (LPD) 是一种异常的脑电图 (EEG) 模式，最常见于患有急性病理状况的危重患者，而在包括颞叶癫痫 (TLE) 在内的局灶性癫痫等慢性疾病中则较少观察到。 ）。在这里，我们旨在探索 TLE 中 LPD 的病理生理机制。方法 我们回顾性选择了 3 名同时接受脑电图和皮层电图 (ECoG) 并显示 LPD 的耐药 TLE 患者。我们分析了脑电图和心电图结果之间的相关性。结果 在患者 1 和 2 中，在发作间期头皮颞区记录到 LPD，此时重复的尖峰随后出现慢波（棘波复合波；SWs) 和周期性放电 (PDs) 的幅度 >600 到 800 µV 出现在外侧颞叶的皮质区域 >10 cm2。在患者 3 中，当发作期放电持续并局限于内侧颞叶时，在外侧颞叶上会引发反复的 SW。当在>10 cm2 的外侧颞叶区域出现幅度>800 µV 的重复SWs 时，相应的脑电图放电出现在颞部头皮上。结论 TLE 患者的 LPD 来源于颞外侧叶的反复 SW 和 PD，这可能代表了发作间期和发作期期间外侧颞叶皮质的高度易怒状态。当发作期放电持续并局限于内侧颞叶时，会在外侧颞叶上引发反复的 SW。当在>10 cm2 的外侧颞叶区域出现幅度>800 µV 的重复SWs 时，相应的脑电图放电出现在颞部头皮上。结论 TLE 患者的 LPD 来源于颞外侧叶的反复 SW 和 PD，这可能代表了发作间期和发作期期间外侧颞叶皮质的高度易怒状态。当发作期放电持续并局限于内侧颞叶时，会在外侧颞叶上引发反复的 SW。当在>10 cm2 的外侧颞叶区域出现幅度>800 µV 的重复SWs 时，相应的脑电图放电出现在颞部头皮上。结论 TLE 患者的 LPD 来源于颞外侧叶的反复 SW 和 PD，这可能代表了发作间期和发作期期间外侧颞叶皮质的高度易怒状态。