灰质异位症所致癫痫的临床表现与视频脑电图特征分析

Video-EEG and Clinical Characteristics of Heterotopic Gray Matter Induced Epilepsy

目的分析灰质异位症的临床表现与视频脑电图特征。方法MRI确诊灰质异位症患者14例,分析其起病年龄、发作形式等临床资料与清醒期、睡眠期和发作期的视频脑电图特征。结果14例患者精神发育正常,神经系统查体未见定位体征。癫痫起病年龄为5～21岁,平均11.4岁。发作形式以继发全面性强直-阵挛发作(sGTCS)和复杂部分性发作(CPS)常见,其次为全面性强直-阵挛发作(GTCS)。灰质异位症患者视频脑电图监测痫性放电与异位灰质部位相关;10例患者存在颞叶的痫性放电,3例患者脑电图监测到起源于颞叶的发作。结论灰质异位症所致癫痫发病年龄早,发作形式以sGTCS和CPS常见。异位灰质部位和颞叶的异常放电是灰质异位症患者的脑电图特征。

Objective To analyze the clinical performance and video - EEG characteristics of gray matter heterotopia. Methods We collected fourteen patients with gray matter heterotopia confirmed by the MRI, and then analyzed their clinical materials, including the onset age of seizure, forms of attack, the characteristics for video - EEG during the phase of interictal and ictal. Results All patients had no mental problem and abnormal signs of nervous system. Their age ranges from 5 to 21 and the mean age was 11.4 when they seizure at the first time. In this study, sGTCS and CPS were the common seizure types, followed by GTCS. Our monitoring of video - EEG from patients with gray matter heterotopia indicated the discharge were consistent with the location of heterotopic gray matter and interietal spiking or slow wave activity was found in the temporal structures in ten patients. Seizure origined from the temporal lobe was found in three patients. Conclusion Seizures caused by gray matter heterutopia begin during the second decade of life. sGTCS and CPS are the common seizure types. The electrical features accords with ectopic grey matter and spiking in the temporal structures are two EEG characteristics of the patients with gray matter heterotopia.