伴海马硬化的颞叶癫痫患者的临床特点分析

The characteristics of temporal lobe epilepsy with hippocampal sclerosis

目的通过比较伴和不伴海马硬化的颞叶癫痫患者的临床特点,为临床诊治提供依据。方法收集2009年6月至2012年6月期间南京军区南京总医院颞叶癫痫患者144例,通过头颅MRI或颞叶癫痫手术病理分类,对每位患者发作时临床表现、发作间期、起病年龄及脑电图等进行分析。结果伴海马硬化的颞叶癫痫患者起病年龄较不伴海马硬化的颞叶癫痫患者更小,同时更易出现发作前先兆和意识障碍。伴或不伴海马硬化的颞叶癫痫患者的脑电图异常率相似,大多数患者脑电图可发现癫痫样异常改变。海马硬化患者有高热惊厥史的更常见。结论伴有海马硬化的颞叶癫痫患者有一些特殊的临床表现,深入了解伴海马硬化的颞叶癫痫患者的临床特点将利于更好更快地选择颞叶癫痫患者的合理治疗方案。

Objective To investigate characteristics of temporal lobe epilepsy, the comparison of clinical characteristics with and without hippocampal sclerosis in patients with temporal lobe epilepsy were evaluated.Method A retrospective study was conducted by analyzing clinical, lifestyle data, and interictal EEG collected from 144 patients with temporal lobe epilepsy between June 2009 to June 2012.Result Onset age in patients with temporal lobe epilepsy associated with hippocampal sclerosis was smaller than without hippocampal sclerosis, and aura and disturbance of consciousness were more common. The EEG abnormal rate was 70.14%, but there was no difference in the EEG abnormal rate between patients with or without hippocampal sclerosis. Patients with hippocampal sclerosis were significantly associated with febrile seizures. Conclusion This retrospective study suggests that some special clinical manifestations associated with patients with hippocampal sclerosis. In-depth understanding of clinical characteristics associated with patients with hippocampal sclerosis will favor the reasonable diagnosis and treatment of patients with temporal lobe epilepsy.