中华神经外科杂志
中華神經外科雜誌
중화신경외과잡지
Chinese Journal of Neurosurgery
2014年
10期
1050-1052
,共3页
张冰清%周文静%孙朝晖%石岩芳%张光明%贺晶%林久銮%左焕琮
張冰清%週文靜%孫朝暉%石巖芳%張光明%賀晶%林久鑾%左煥琮
장빙청%주문정%손조휘%석암방%장광명%하정%림구란%좌환종
癫痫,颞叶%海马硬化%先兆发作%自动症发作
癲癇,顳葉%海馬硬化%先兆髮作%自動癥髮作
전간,섭협%해마경화%선조발작%자동증발작
Epilepsy,temporal lobe%Hippocampal sclerosis%Aura seizures%Automotor seizures
目的 分析伴海马硬化的内侧颞叶癫痫患者的症状学特点及定侧价值.方法 对2011年1月至2012年6月行选择性内侧颞叶结构切除术后无发作的14例癫痫患者的症状学进行回顾性分析.结果 14例患者共记录57次癫痫临床发作,其中11次在睡眠中,46次在清醒期.10例有先兆发作,所有患者均有自动症发作,13例有植物神经发作心动过速,6例记录到头眼同侧偏斜,2例有头眼对侧偏斜,12例对侧上肢强直,4例头眼对侧偏转,5例有继发全身强直-阵挛发作,3例有发作后同侧上肢摸鼻或面部.结论 伴海马硬化内侧颞叶癫痫的主要发作表现:先兆发作→自动症发作→植物神经发作心动过速→对侧肢体强直发作,很少继发全身强直-阵挛发作.发作中单侧上肢自动定位于致痫灶同侧;单侧肢体强直及头眼偏转发作常定位于致痫灶对侧;发作中头眼一侧偏斜主要见于致痫灶同侧,而先兆发作无明确定侧价值.
目的 分析伴海馬硬化的內側顳葉癲癇患者的癥狀學特點及定側價值.方法 對2011年1月至2012年6月行選擇性內側顳葉結構切除術後無髮作的14例癲癇患者的癥狀學進行迴顧性分析.結果 14例患者共記錄57次癲癇臨床髮作,其中11次在睡眠中,46次在清醒期.10例有先兆髮作,所有患者均有自動癥髮作,13例有植物神經髮作心動過速,6例記錄到頭眼同側偏斜,2例有頭眼對側偏斜,12例對側上肢彊直,4例頭眼對側偏轉,5例有繼髮全身彊直-陣攣髮作,3例有髮作後同側上肢摸鼻或麵部.結論 伴海馬硬化內側顳葉癲癇的主要髮作錶現:先兆髮作→自動癥髮作→植物神經髮作心動過速→對側肢體彊直髮作,很少繼髮全身彊直-陣攣髮作.髮作中單側上肢自動定位于緻癇竈同側;單側肢體彊直及頭眼偏轉髮作常定位于緻癇竈對側;髮作中頭眼一側偏斜主要見于緻癇竈同側,而先兆髮作無明確定側價值.
목적 분석반해마경화적내측섭협전간환자적증상학특점급정측개치.방법 대2011년1월지2012년6월행선택성내측섭협결구절제술후무발작적14례전간환자적증상학진행회고성분석.결과 14례환자공기록57차전간림상발작,기중11차재수면중,46차재청성기.10례유선조발작,소유환자균유자동증발작,13례유식물신경발작심동과속,6례기록도두안동측편사,2례유두안대측편사,12례대측상지강직,4례두안대측편전,5례유계발전신강직-진련발작,3례유발작후동측상지모비혹면부.결론 반해마경화내측섭협전간적주요발작표현:선조발작→자동증발작→식물신경발작심동과속→대측지체강직발작,흔소계발전신강직-진련발작.발작중단측상지자동정위우치간조동측;단측지체강직급두안편전발작상정위우치간조대측;발작중두안일측편사주요견우치간조동측,이선조발작무명학정측개치.
Objective To study the semiological characteristics of mesial temporal lobe epilepsy (MTLE) with hippocampal sclerosis(HS).Methods The semiology of 14 patients with MTLS,who had seizures-free at least for one year after selective hippocampus-amygadala resection from January 2011 to June 2012 were retrospectively analyzed.Results Fifty-seven epileptic seizures were recorded in 14 patients.11 seizures occurred in sleep,while 46 in awake.10 patients had auras seizures.All patients had automatism seizure.13 patients had autonomic seizures with tachycardia.6 patients'head and eyes deviated to the ipsilateral side.2 patients'head and eyes deviated to the contralateral side.12 patients had contralateral upper limb tonic.4 patients had contralateral version.5 patients had secondary generalized tonic-clonic seizures.3 patients used ipsilateral hand touching nasal or facial postictal.Conclusions The main seizures of MTLE with HS manifested:aura seizure→automatism seizure→autonomic seizure(tachycardia) →contralateral limb tonic seizures,rarely secondarily GTCS.The unilateral upper limbic automotor during the ictal period was located ipsilateral to epileptogenic side.The unilateral limb tonic and head version was often located contralateral to the epileptogenic side.Head and eyes' deviation were mainly seen at the same side of the epileptogenic focus.Aura seizures had no lateralized value.
