Abstract：
OBJECTIVE: To describe blinking as the only manifestation of seizures from isolated focal and generalized cortical spikes and investigate the relationship between blinks and epileptic discharges.
METHODS: We measured the latency from the onset of spikes to the onset of blinks in two patients using electroencephalogram (EEG) and an electrooculogram (EOG), and calculated the median latency in both cases. We analyzed the latency from spike onset to the onset of additional specific eye movements, seen only in the second case. To determine the frequency of spontaneous blinks (not triggered by spikes), we defined a \"control point\" at 45 s following a random spike for the first case. We tested for statistically significant associations between latencies of blinks (Case 1) as well as between latencies of blinks and specific eye movements (Case 2).
RESULTS: A total of 174 generalized spike-waves followed by a blink were analyzed in the first patient. Approximately 61% of the blinks occurred within 150-450 ms after the onset of the spike. Median latency for blinks following a spike was 294 ms compared to 541 ms for control blinks (p = .02). For the second patient, a total of 160 eye movements following a right occipito-parietal spike were analyzed. The median spike-blink latency in the second case was 497 milliseconds. Median latencies of spike onset to contralateral oblique eye movements with blink and left lateral eye movements were 648 and 655 milliseconds, respectively.
CONCLUSIONS: Our study shows that isolated cortical spikes can induce epileptic seizures consisting exclusively of blinks. These findings emphasize the importance of careful EEG and EOG analysis to determine blinking as the only ictal phenomenon. We additionally describe a new technique to prove the temporal relationship between cortical discharges and a specific movement when, in addition to the movements triggered by a spike, the same movement is also spontaneously performed by the patient (in this case, blinking).
METHODS: We measured the latency from the onset of spikes to the onset of blinks in two patients using electroencephalogram (EEG) and an electrooculogram (EOG), and calculated the median latency in both cases. We analyzed the latency from spike onset to the onset of additional specific eye movements, seen only in the second case. To determine the frequency of spontaneous blinks (not triggered by spikes), we defined a \"control point\" at 45 s following a random spike for the first case. We tested for statistically significant associations between latencies of blinks (Case 1) as well as between latencies of blinks and specific eye movements (Case 2).
RESULTS: A total of 174 generalized spike-waves followed by a blink were analyzed in the first patient. Approximately 61% of the blinks occurred within 150-450 ms after the onset of the spike. Median latency for blinks following a spike was 294 ms compared to 541 ms for control blinks (p = .02). For the second patient, a total of 160 eye movements following a right occipito-parietal spike were analyzed. The median spike-blink latency in the second case was 497 milliseconds. Median latencies of spike onset to contralateral oblique eye movements with blink and left lateral eye movements were 648 and 655 milliseconds, respectively.
CONCLUSIONS: Our study shows that isolated cortical spikes can induce epileptic seizures consisting exclusively of blinks. These findings emphasize the importance of careful EEG and EOG analysis to determine blinking as the only ictal phenomenon. We additionally describe a new technique to prove the temporal relationship between cortical discharges and a specific movement when, in addition to the movements triggered by a spike, the same movement is also spontaneously performed by the patient (in this case, blinking).
摘要：
目的：将眨眼描述为孤立的局灶性和全身性皮质尖峰的癫痫发作的唯一表现，并研究眨眼与癫痫放电之间的关系。
方法：我们使用脑电图（EEG）和眼电图（EOG）测量了两名患者从尖峰发作到眨眼发作的潜伏期，并计算了两种情况下的中位潜伏期。我们分析了从尖峰开始到其他特定眼球运动开始的潜伏期，只在第二种情况下看到。要确定自发闪烁的频率（不是由尖峰触发的），对于第一种情况，我们在随机尖峰之后的45s定义了一个“控制点”。我们测试了眨眼延迟之间（案例1）以及眨眼延迟与特定眼球运动之间（案例2）的统计学显着关联。
结果：分析了第一例患者的174个广义尖峰波，然后眨眼。大约61%的眨眼发生在尖峰开始后的150-450ms内。与对照闪烁的541ms相比,尖峰后闪烁的延迟中值为294ms(p=.02)。第二个病人,共分析了右枕顶尖峰后的160次眼球运动.第二种情况下的峰值闪烁延迟中位数为497毫秒。峰值发作到对侧斜眼运动的眨眼和左眼运动的中位潜伏期为648和655毫秒，分别。
结论：我们的研究表明，孤立的皮质尖刺可以诱发癫痫发作，仅由眨眼组成。这些发现强调了仔细的EEG和EOG分析以确定眨眼是唯一的发作现象的重要性。我们还描述了一种新技术来证明皮质放电和特定运动之间的时间关系，除了由尖峰触发的运动之外，患者也自发地进行相同的运动（在这种情况下，闪烁)。
方法：我们使用脑电图（EEG）和眼电图（EOG）测量了两名患者从尖峰发作到眨眼发作的潜伏期，并计算了两种情况下的中位潜伏期。我们分析了从尖峰开始到其他特定眼球运动开始的潜伏期，只在第二种情况下看到。要确定自发闪烁的频率（不是由尖峰触发的），对于第一种情况，我们在随机尖峰之后的45s定义了一个“控制点”。我们测试了眨眼延迟之间（案例1）以及眨眼延迟与特定眼球运动之间（案例2）的统计学显着关联。
结果：分析了第一例患者的174个广义尖峰波，然后眨眼。大约61%的眨眼发生在尖峰开始后的150-450ms内。与对照闪烁的541ms相比,尖峰后闪烁的延迟中值为294ms(p=.02)。第二个病人,共分析了右枕顶尖峰后的160次眼球运动.第二种情况下的峰值闪烁延迟中位数为497毫秒。峰值发作到对侧斜眼运动的眨眼和左眼运动的中位潜伏期为648和655毫秒，分别。
结论：我们的研究表明，孤立的皮质尖刺可以诱发癫痫发作，仅由眨眼组成。这些发现强调了仔细的EEG和EOG分析以确定眨眼是唯一的发作现象的重要性。我们还描述了一种新技术来证明皮质放电和特定运动之间的时间关系，除了由尖峰触发的运动之外，患者也自发地进行相同的运动（在这种情况下，闪烁)。
