首页> 外文期刊>Epilepsia: Journal of the International League against Epilepsy >Reduction of EEG myogenic artifact with botulinum toxin during video-EEG monitoring.
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Reduction of EEG myogenic artifact with botulinum toxin during video-EEG monitoring.

机译:在视频脑电图监测过程中,肉毒杆菌毒素可减少脑电图肌假象。

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摘要

PURPOSE: To determine whether EEG myogenic artifact during video-EEG monitoring (VEM) is reduced with targeted scalp botulinum toxin (BTX-A) injections. METHODS: Twelve consecutive patients scheduled for presurgical VEM were treated 2-3 weeks before admission with subcutaneous BTX-A injections at specific EEG electrode locations. On the basis of clinical data available before VEM, four subjects were treated unilaterally (group 1) and eight bilaterally (group 2). BTX-A efficacy was assessed quantitatively in group 1 subjects by comparing high-frequency (20-100 Hz) power at homologous "treated" and "untreated" electrodes during voluntary forceful jaw closure. The clinical impact of BTX-A treatment was assessed by determining whether > or =5 of the first 10 s of each ictal recording was obscured by muscle artifact, and whether residual myogenic artifact on BTX-A-"treated" electrodes rendered these ictal EEG segments impossible to interpret. RESULTS: BTX-A treatment reduced high-frequency power by a mean of 53% at electrodes T3/T4 and 52% at electrodes F7/F8. None of 49 ictal EEGs had > or =5 of the first 10 s obscured by myogenic artifact, and all of these ictal epochs were interpretable. Adverse events were limited to two subjects who complained of transient difficulty chewing tough foods. CONCLUSIONS: Scalp-muscle BTX-A treatment before VEM significantly reduces myogenic artifact in subsequent EEG recordings, including ictal EEG. The clinical utility of this technique for improved or more-rapid seizure localization will be determined only by large, blinded, prospective trials.
机译:目的:确定是否有针对性的头皮肉毒杆菌毒素(BTX-A)注射减少了视频-EEG监测(VEM)期间的EEG肌源性假象。方法:入院前2-3周,连续12例计划在术前进行VEM的患者在特定EEG电极位置经皮下BTX-A注射治疗。根据VEM之前可获得的临床数据,对4名受试者进行了单侧治疗(第1组),对8名双侧治疗了(第2组)。在第1组受试者中,通过比较自愿强行闭合颌骨时在同种“治疗”电极和“未治疗”电极上的高频(20-100 Hz)功率,定量评估了BTX-A的疗效。 BTX-A治疗的临床影响是通过确定每个ictal记录的前10秒是否>或= 5被肌肉伪影掩盖,以及BTX-A-“治疗”电极上是否残留了肌原性伪影来评估这些Etal EEG细分无法解释。结果:BTX-A处理将高频功率在电极T3 / T4上平均降低了53%,在电极F7 / F8上降低了52%。在最初的10 s中,49个发作期EEG中没有一个被肌原性伪影所掩盖或= 5,并且所有这些发作期都是可以解释的。不良事件仅限于两名抱怨咀嚼坚硬食物的短暂困难的受试者。结论:在VEM之前进行头皮肌BTX-A治疗可显着减少随后的EEG记录(包括发作性EEG)中的肌源性伪影。这项技术在改善癫痫发作定位方面的临床应用,只有通过大型,盲目的前瞻性试验才能确定。

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