颞叶内侧癫痫症状学及头皮脑电特征
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摘要
目的探讨伴有海马硬化的颞叶内侧癫痫(MTLE)患者的症状学及头皮脑电特征。方法选取北部战区总医院自2015年1月至2018年6月收治的11例行标准前颞+海马切除术患者为研究对象。回顾性分析其症状学及脑电图特征。结果 11例患者均直接进行手术切除,共记录38次癫痫发作,清醒期发作占65. 8%(25/38)。MTLE症状学特点为先兆发作→自动症发作→对侧肢体强直发作/肌张力障碍→继发全面强直-阵挛发作。致痫灶同侧放电9例,双侧颞区放电2例,部分患者可表现为向其他脑区扩散。结论 MTLE典型的症状学及脑电图可进一步明确疾病诊断,指导临床治疗。
Objective To investigate the semiology and scalp electroencephalogram characteristics of magnetic resonance positive patients with medial temporal lobe epilepsy accompanied by hippocampal sclerosis. Methods A retrospective study was performed on11 cases of patients who underwent standard anterior temporal and hippocampal resection from January 2015 to June 2018. The symptom and electroencephalogram characteristics were analyzed retrospectively. Results All the 11 patients underwent direct surgical resection. A total of 38 epileptic seizures were recorded,with 65. 8%( 25/38) of them in the awake phase. Semiology characteristics of medial temporal lobe epilepsy: aura-automatism-contralateral tonus/dystonia-secondary total tonus-clonic seizure. There were 9 cases of ipsilateral discharge of epileptic foci and 2 cases of bilateral temporal area discharge,some of which could be manifested as diffusion to other brain areas. Conclusion The typical symptomatology and electroencephalogram of mesial temporal lobe epilepsy can further clarify the diagnosis and guide clinical practice.
Objective To investigate the semiology and scalp electroencephalogram characteristics of magnetic resonance positive patients with medial temporal lobe epilepsy accompanied by hippocampal sclerosis. Methods A retrospective study was performed on11 cases of patients who underwent standard anterior temporal and hippocampal resection from January 2015 to June 2018. The symptom and electroencephalogram characteristics were analyzed retrospectively. Results All the 11 patients underwent direct surgical resection. A total of 38 epileptic seizures were recorded,with 65. 8%( 25/38) of them in the awake phase. Semiology characteristics of medial temporal lobe epilepsy: aura-automatism-contralateral tonus/dystonia-secondary total tonus-clonic seizure. There were 9 cases of ipsilateral discharge of epileptic foci and 2 cases of bilateral temporal area discharge,some of which could be manifested as diffusion to other brain areas. Conclusion The typical symptomatology and electroencephalogram of mesial temporal lobe epilepsy can further clarify the diagnosis and guide clinical practice.
引文
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[2]Scott RC,King MD,Gadian DG,et al.Hippocampal abnormalities after prolonged febrile convulsion:a longitudinal MRI study[J].Brain,2003,126(Pt 11):2551-2557.
[3]Asadi-Pooya AA,Nei M,Rostami C,et al.Mesial temporal lobe epilepsy with childhood febrile seizure[J].Acta Neurol Scand,2017,135(1):88-91.
[4]Ye BS,Cho YJ,Jang SH,et al.The localizing and lateralizing value of areas in lesional partial epilepsy patients[J].Yonsei Med J,2012,53(3):477-485.
[5]Foldvary-Schaefer N,Unnwongse K,Localizing and lateralizing features of auras and seizures[J].Epilepsy Behav,2011,20(2):160-166.
[6]Asadi-Pooya AA,Nei M,Sharan A,et al.Type of preoperative aura may predict postsurgical outcome in patients with temporal lobe epilepsy and mesial temporal sclerosis[J].Epilepsy Behav,2015,50:98-100.
[7]Wennberg R.Postictal coughing and nose rubbing coexist in temporal lobe epilepsy[J].Neurology,2001,56(1):133-134.
[8]So EL.Value and limitations of seizure semiology in localizing seizure onset[J].J Clin Neurophysiol,2006,23(4):353-357.
[9]Wennberg R.Electroclinical analysis of postictal noserubbing[J].Can J Neurol Sci,2000,27(2):131-136.