内侧额叶癫痫发作的临床特征分析

A clinical study on mesial frontal epilepsy

目的 分析内侧额叶癫痫发作的临床特征。方法 回顾性分析 10例经手术证实的内侧额叶起源的癫痫患者 12 9次临床发作症状 ,脑电图表现 ,致痫灶定位及手术结果等临床资料。结果 内侧额叶癫痫发作的常见形式包括 :过度运动发作、姿势性强直发作、额叶失神发作等 ,多在夜间发作 ,持续时间较短暂。 10例均应用颅内电极进行长程记录定位致痫灶。致痫灶位于辅助运动区 2例 ,内侧额回 4例 ,额极 1例 ,眶额区 1例 ,扣带回 1例 ,扣带回及额上回 1例。按照Engel术后效果进行分级 ,Ⅰ级 3例 ,Ⅱ级 2例 ,Ⅲ级 3例 ,2例随访时间未满 1年。 结论 内侧额叶癫痫发作具有一定的特征性。普通头皮脑电图定位致痫灶常较困难 ,需要应用颅内电极。

Objective To analysis the clinical traits of mesial frontal epilepsy.Methods Retrospectively evaluated the seizure manifestations,EEG,localization of epileptogenic zones and surgical outcome in 10 cases verified as patients with seizures originated from the mesialfrontal cortex by successful recestion.Results Most of mesial frontal lobe seizures were frequent,brief and noctural preponderance.The common ictal manifestations were hypermotor seizures,postural tonic seizures,frontal absence seizures.Chronic intracranial electrical recording was applied in all patients to localize epileptogenic zones.Epileptogenic zones were localized in supplementary motor area in 2 cases,mesial frontal gyrus in 4 cases,cingulate gyrus in 2 cases,frontal pole and orbitofrontal cortex in 1 case respectively.Eight patients have been followed up more than 1 year.Class Ⅰ was found in 3 patients;Class Ⅱ in 2 patients and Class Ⅲ in 3 patients.Conclusion Seizures originate from the mesial frontal cortex demonstrate some clinical characterstics.The electrocorticography monitoring with chronic intracranial electrodes may play important roles in the surgical treatment for mesial frontal epilepsy.The surgical outcome can be satisfied when epileptogenic zone is localized.