Beyond the Double Banana: Improved Recognition of Temporal Lobe Seizures in Long-Term EEG

作者：Rosenzweig Ivana; Fogarasi Andras; Johnsen Birger; Alving Jorgen; Fabricius Martin Ejler; Scherg Michael; Neufeld Miri Y; Pressler Ronit; Kjaer Troels W; Boas Walter van Emde; Beniczky Sandor^*

来源：Journal of Clinical Neurophysiology, 2014, 31(1): 1-9.

• Inferior temporal electrodes
• Spectral source analysis
• Virtual and source montages
• Voltage and phase maps

Purpose: To investigate whether extending the 10-20 array with 6 electrodes in the inferior temporal chain and constructing computed montages increases the diagnostic value of ictal EEG activity originating in the temporal lobe. In addition, the accuracy of computer-assisted spectral source analysis was investigated.
Methods: Forty EEG samples were reviewed by 7 EEG experts in various montages (longitudinal and transversal bipolar, common average, source derivation, source montage, current source density, and reference-free montages) using 2 electrode arrays (10-20 and the extended one). Spectral source analysis used source montage to calculate density spectral array, defining the earliest oscillatory onset. From this, phase maps were calculated for localization. The reference standard was the decision of the multidisciplinary epilepsy surgery team on the seizure onset zone. Clinical performance was compared with the double banana (longitudinal bipolar montage, 10-20 array).
Results: Adding the inferior temporal electrode chain, computed montages (reference free, common average, and source derivation), and voltage maps significantly increased the sensitivity. Phase maps had the highest sensitivity and identified ictal activity at earlier time-point than visual inspection. There was no significant difference concerning specificity.
Conclusions: The findings advocate for the use of these digital EEG technology-derived analysis methods in clinical practice.

• 出版日期2014-2