Background

Single-lesion neurocysticercosis provides a model of seizure genesis secondary to an acquired lesion. We aimed to study the correlation of seizure semiology with the location of the lesion and interictal electroencephalographic (EEG) abnormalities in children with single-lesion neurocysticercosis. Methods: Prospective, observational study in children with single-lesion neurocysticercosis and seizures. Seizure classification was done after an interview with the parent/onlooker and the child. Localization and lateralization of the lesion were done by neuroimaging. The EEG abnormalities were classified based on their morphology and location. Results: Ninety-two children (7.9 ± 2.4 years) were included. Focal-onset seizures were the commonest (n = 54; 58.6%) seizures. Majority of the lesions were located in the frontal (n = 43; 47%) and parietal cortex (n = 34; 37%). EEG showed focal slowing (n = 15; 53.6%) and epileptiform spikes/spike-wave complexes (n = 13; 46.4%). There was a perfect agreement of clinical semiology with imaging lateralization (K = 1.0) and moderate agreement with imaging localization (K = 0.4). There was no significant agreement of clinical localization with EEG slowing (K = 0.1) or sharps (K = 0). There was moderate agreement (K = 0.6) of EEG slowing and substantial agreement (K = 0.7) of EEG sharps with clinical lateralization. Focal EEG slowing had moderate (K = 0.5) agreement with imaging lateralization. Focal sharps/spikes had substantial (K = 0.7) agreement with imaging lateralization. The positive predictive value (PPV) of seizure semiology for lateralization and localization was 100% and 68%, respectively. PVV of focal sharps for lateralization and localization was 84% and 70%, respectively. PPV of focal slowing for lateralization and localization was 77% and 65%, respectively. Conclusion: Seizure semiology in single-lesion neurocysticercosis correlates very well with lateralization but not so well with localization of lesion on neuroimaging. Focal EEG abnormalities are seen in nearly one-third of children with single-lesion neurocysticercosis. EEG often predicts the side of the lesion but has poor localizing value.

中文翻译：

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单病灶神经囊尾蚴病儿童的癫痫发作症状学、神经影像学病灶位置和发作间期脑电图 (EEG) 异常——是否存在相关性？

 背景

单病灶神经囊尾蚴病提供了继发于获得性病灶的癫痫发作发生模型。我们的目的是研究单病灶神经囊尾蚴病儿童癫痫发作症状学与病灶位置和发作间期脑电图（EEG）异常的相关性。方法：对患有单病灶神经囊尾蚴病和癫痫发作的儿童进行前瞻性观察性研究。癫痫发作分类是在与家长/旁观者和孩子面谈后进行的。通过神经影像学进行病变的定位和偏侧化。脑电图异常根据其形态和位置进行分类。结果：包括 92 名儿童（7.9 ± 2.4 岁）。局灶性癫痫发作是最常见的（n = 54；58.6%）癫痫发作。大多数病变位于额叶皮质（n = 43；47%）和顶叶皮质（n = 34；37%）。脑电图显示局灶性减慢（n = 15；53.6%）和癫痫样棘波/棘波复合体（n = 13；46.4%）。临床符号学与影像偏侧化（K = 1.0）完全一致，与影像定位（K = 0.4）中等一致。临床定位与脑电图减慢（K = 0.1）或锐利（K = 0）没有显着一致性。脑电图减慢与临床侧化有中等程度的一致性（K = 0.6），而脑电图尖锐与临床侧化有显着的一致性（K = 0.7）。局灶性脑电图减慢与成像偏侧化具有中等程度的一致性（K = 0.5）。焦点尖峰/尖峰与成像偏侧化有很大的一致性（K = 0.7）。癫痫症状学对偏侧化和定位的阳性预测值 (PPV) 分别为 100% 和 68%。侧化和定位的焦点锐利的 PVV 分别为 84% 和 70%。 侧化和定位焦点减慢的 PPV 分别为 77% 和 65%。结论：单病灶神经囊尾蚴病的癫痫发作症状学与单侧化有很好的相关性，但与神经影像学上病灶的定位相关性不太好。近三分之一的单病灶神经囊尾蚴病儿童可见局灶性脑电图异常。脑电图通常可以预测病变的一侧，但定位价值较差。