[1]张冰清,周文静,王海洋.起源于颞后-枕交界区癫痫的电-临床研究[J].临床神经外科杂志,2015,(03):176-180.
点击复制

起源于颞后-枕交界区癫痫的电-临床研究()
分享到:

《临床神经外科杂志》[ISSN:1672-7770/CN:32-1727/R]

卷:
期数:
2015年03期
页码:
176-180
栏目:
癫痫专题 论著
出版日期:
2015-06-15

文章信息/Info

Title:
Electro-Clinical Characteristics of Temporo-Occipital Conjunction Epilepsy
作者:
张冰清 周文静 王海洋
清华大学玉泉医院
关键词:
癫痫颞后-枕皮层后头部癫痫致痫区
Keywords:
Epilepsy Temporo-occipital cortex Posterior cortex epilepsy Epileptogenic zone
分类号:
R742.1
文献标志码:
A
摘要:
目的:探讨神经影像学、电生理及症状学在起源于颞后-枕交界区癫痫患者术前评估中的价值。方法学:回顾性分析2010年1月至2012年12月清华大学玉泉医院神经外科五病区经颅内电极证实发作起源于颞后-枕交界区的7癫痫患者,术后随访1年以上无发作,分析其头颅MRI、电生理及发作症状学特点及定侧、定位信息。结果:⑴头颅MRI:3例患者致痫区同侧颞枕交界区、枕叶或颞顶枕交界区病灶,2例患者致痫区同侧海马硬化,2例阴性。⑵间歇期放电脑区:2例为致痫区同侧后头部,3例为累及额、颞及后头部等多脑区,其中致痫区同侧颞区著1例,致痫区同侧后头部著2例;2例为致痫区同侧半球弥漫性,颞区著1例,后头部著1例。⑶发作期脑电图:3例为致痫区同侧后头部起始;4例为弥漫性起始,致痫区同侧后头部著2例,致痫区同侧颞区著1例,同侧半球著1例。⑷发作症状学:6例患者视觉先兆,1例患者有头部先兆;5例患者有自动症发作,6例患者对侧肢体强直/强直-阵挛,其中4例患者既有自动症发作又有强直发作。结论:与头颅MRI相比,间歇期VEEG、发作期VEEG及症状学提供了更多的定侧、定位信息,特别是症状学先兆及体征的定侧及定位信息更大。而头颅MRI在一定程度上可以造成误导,往往出现致痫灶同侧颞叶内侧结构的信号异常。
Abstract:
Objectiv: To study the lateralized and localized values of neuroimaging,electrophysiology and clinical symptomatology on the temporo-occipital conjunction epilepsy. Method: Retrospective analysed the MRI, electrophysiological and seizure semiology of 7 temporo-occipital conjunction epilepsy patients after intracranial electrode confirmed during January 2010 to December 2012 in Department five of Neurosurgery of Yuquan Hospital of Tsinghua University. Patients were without seizures postoperation for at least 1 year. Result: ⑴Three patients’MRI showed lesion on ipsilateral temporo-occtipital conjunction, temporal lobe or temporo-parieto-occipital lobe. Two patients’MRI showed ipsilateral hippocampus sclerosis. Two patients’MRI were normal.⑵ Iterictal EEG: 2 patients had ipsilateral posterior head discharges,3 patients had multiple brain regions discharges including frontal, temporal and posterior cortex. 2 patients had diffused discharges, one patient temporal dorminant, one patient posterior region dorminant.⑶Ictal EEG showed ipsilateral posterior cortex onset in 3 patients and diffused onset in 4 patient, which posterior cortex dorminant in 2 patients, temporal region dorminant in 1patient and ipsilateral hemisphere dorminant in 1patient.⑷Semiology:6patients had visual aruas, 1 patient had cephalic arua, 5 patients had aurtomatis sezure. 6 patients had contralateral limbs tonic or tonic-clonic sezuire. And 4 patients had automatism seizure and tonic seizure。Conclusion: Compared with the head MRI, interictal VEEG, ictal VEEG and symptomatology provides more information for location epileptogenic zone, especially the aura seizure and signs. And head MRI were misleading to some extent, often showed ipsilateral medial temporal lobe structure signal abnormalities.

相似文献/References:

[1]秦兵.特别适合于癫痫术前评估的脑电图分级诊断体系[J].临床神经外科杂志,2015,(03):161.
[2]林久銮,周文静,孙朝晖.半球性病变癫痫外科术式选择策略[J].临床神经外科杂志,2015,(03):163.
[3]吴婷,刘宏毅,张锐.脑磁图静息态脑网络定位与皮质脑电图的对照研究[J].临床神经外科杂志,2015,(03):168.
[4]张光明,韩宏彦,徐金山.涉及中央前回的顽固性癫痫外科治疗[J].临床神经外科杂志,2015,(03):189.
[5]朱敏伟,沈红,刘利,等.功能性大脑半球切除术治疗婴幼儿性偏瘫伴顽固性癫痫2例并文献复习[J].临床神经外科杂志,2015,(03):192.
[6]王圆庆,姚一,江建东,等.大脑半球切除术治疗2例4月龄症状性West综合征报告及文献复习[J].临床神经外科杂志,2015,(03):205.
[7]高登科,姚一,江建东,等.伴发癫痫的优势半球外侧裂脑动静脉畸形手术治疗1例并文献复习[J].临床神经外科杂志,2015,(03):209.
[8]牛弘川,翟锋,周健.结节性硬化合并节细胞胶质瘤所致癫痫的外科治疗[J].临床神经外科杂志,2015,(03):217.
[9]夏松松,林志国.岛叶癫痫进展[J].临床神经外科杂志,2015,(04):306.
[10]徐翠萍,杜薇,李勇杰.癫痫患者大脑网络研究进展[J].临床神经外科杂志,2014,(03):232.

备注/Memo

备注/Memo:
[收稿日期] 2014-11-13 [基金项目]国家重点基础研究发展计划(973计划)
更新日期/Last Update: 2015-06-15