额叶癫痫发作录像脑电图特点分析

Evaluation of ictal video EEG in frontal origin seizures

目的通过录像脑电图观察额叶癫痫的临床特征、发作期及发作间歇期的脑电图特点。方法使用录像脑电图（ｖｉｄｅｏＥＥＧ，ＶＥＥＧ）对５０例确诊为额叶癫痫的患者进行常规及长时间记录，对其中１７例（２０次）癫痫发作的临床表现及脑电图所见进行分析。结果额叶癫痫常见的发作形式有：姿势性发作，具有额叶癫痫特点的自动症；复杂部分性发作时伴发声、偏转或表情的变化，有时出现发作性情绪改变或强迫思维等少见症状。其发作特点为：持续时间短，发作相对较频繁，无明显发作后意识障碍。发作间歇期脑电图有时可无阳性所见，典型的临床发作及发作时ＶＥＥＧ记录到的额部爆发性节律有助于诊断。本组９例儿童期起病的额叶癫痫患者，以夜间频繁的躯体自动症发作为主，检查均未发现相应的脑器质性病变。脑电图睡眠描记可见频繁的额部导联癫痫样放电。临床治疗观察预后良好，提示可能为一组儿童原发性部分发作型癫痫综合征。结论额叶癫痫是一组较为特征性的癫痫综合征，临床并不少见，及时而正确的诊断有助于治疗。

Objective The study is to evaluate clinical features, ictal and interictal EEG characteristics in the patients diagnosed as frontal lobe epilepsy. Methods Clinical data and EEG findings were subject to the comparison in 50 cases based on routine and long term video EEG (VEEG) recordings, especially on 20 frontal seizures recorded. Results 20 ictal seizures in 17 cases showed the characteristics of typical frontal lobe origin as follows: postural seizures, gestural automatism, vocalization, adversive seizures and changes in expressions. Frontal lobe seizures were often exhibited in relatively short durations, whereas the frequent nocturnal attacks usually occurred without postictal mental confusion. The ictal epileptic discharges might be of assistance for their diagnoses in view of the lack of interictal EEG positive findings in some cases. Nine of the 50 cases were clinically corresponded to a group of benign frontal lobe epilepsy in children. Conclusion Practically the frontal lobe epilepsy was not so uncommon. Ictal monitoring using video EEG might be helpful for its diagnosis and treatment.