“4 ”字征在颞叶内侧癫癎致癎源定侧中的应用价值

Lateralizing significance of figure ＂4＂ sign in patients with mesial temporal lobe epilepsy

目的探讨“4”字征在颞叶内侧癫癎（MTLE）致癎源定侧中的应用价值。方法对33例确诊为MTLE并行手术治疗和术后长期随诊（≥4年）无发作的患者术前发作录像进行回顾性的分析，重点关注54次继发性全面强直-阵挛发作（sGTC）出现的＂4＂字征与致癎源侧别的关系。结果在33例MTLE患者的共54次sGTC中，有10例（30％）患者的23次（43％）sGTC出现了“4”字征，所有＂4＂字征的上肢伸直侧均位于致癎源（切除侧）的对侧。结论在本组MTLE患者中，尽管＂4＂字征的发生率低，但有较高的致癎源定侧准确性。

Objective To investigate the lateralizing value of figure ＂4＂ sign, an asymmetrical tonic posturing observed in secondarily generalized tonic-clonic seizures （ sGTC ） , in patients with mesial temporal lobe epilepsy. Methods Presurgical videotapes of 54 sGTC from 33 patients who were seizure-free for at least 4 years after temporal lobectomy were retrospectively reviewed. Attention was paid to the relationship between the extended upper extremity in figure ＂4＂ sign and the resected side, Results The ＂4＂ sign was observed in 10 （30%） of 33 patients and 23（43% ） of sGTC. The extended ann in figure ＂4＂ sign was always contralateral to the epileptogenic loci （resected side ）. Conclusion ＂4＂ sign has a significant lateralizing value, when present, in this selected homogeneous group of patients.