额叶癫癎患者的临床特点及脑电分析

Clinical characteristics and EEG changes of patients with frontal lobe epilepsy

目的 :观察额叶癫患者的临床特点、EEG表现、治疗方法及效果。方法 :回顾性分析 62例额叶癫患者的临床表现、发作期及发作间期EEG改变和抗癫药物的治疗效果。结果 :额叶癫常见的发作形式为复杂部分性发作 (82 % ) ,主要表现为假自主运动 ,发声及重复语言 ,姿势性强直 ,并伴有发作持续时间短、频繁发作、发作后神志恢复快等特点。发作期EEG样放电检出率 10 0 % ,但能定位额区仅占 74% ,发作间期EEG 8例无阳性发现。经抗癫药物治疗 ,有效率达 93 % ,其中 5 0 %完全控制发作 ,主要用药为卡马西平。随访 2～ 5年 ,仍有效者占 88%。结论 :额叶癫为一组以运动症状为主要表现的特征性癫综合征 。

Objective:To observe the clinical characteristics,EEG changes ,treatment and outcome in patients with frontal lobe epilepsy (FLE).Methods:The clinical features,ictal and interictal EEG changes ,therapeutic effect with antiepileptic drugs in 62 patients with FLE was analysed retrospectively .Results:The common seizure type in FLE was complex partial seizure (82%).The main manifestations included pseudovoluntary movement,vocalization,repeating pronunciation and gestural seizures.The seizures in FLE also exhibited the characteristics of short durations ,frequent attacks and prompt recovery of consciousness after seizures.The epileptic discharges in ictal EEG were found in all patients(100%),but could be localized in frontal region in only 28 patients (74%) .The interictal EEG showed no positive findings in 8 cases .After therapy with antiepileptic drugs, the effective rate reached 93% .Seizure-free had been achieved in 50% of the cases.The effective antiepileptic drug for FLE was carbamazepine.Following up for 2 to 5 years,it was found that 88% of the patients still had a ≥50% reduction in seizure frequency.Conclusion:FLE might be a special epileptic syndrome which often exhibits seizures with motor symptom.Carbamazepine might be an effective antiepileptic drug for FLE.