CAJ | 학술논문

目的：探讨复杂部分发作（CPS）中上肢肌张力障碍姿势（DP）在药物难治性颞叶内侧癫痫（ MTLE）致痫区定侧中的应用价值。方法对北京协和医院1997—2011年间89例MTLE并行手术治疗及术后长期随诊（≥2年）的患者术前发作录像进行回顾性的分析，重点关注DP出现时间及其与致痫区的侧别关系。结果在89例MTLE患者共424次CPS中，有37例（41．6％）患者的共92次CPS中出现了DP。绝大多数（92％） DP出现在发作中期，而不是发作的首发表现。 DP出现的对侧多提示为致痫区侧，其定侧致痫区的阳性预测值（ PPV）为93．9％。结论在MTLE中，DP是一种可靠的定位体征，具有较高定侧致痫区价值。
목적：탐토복잡부분발작（CPS）중상지기장력장애자세（DP）재약물난치성섭협내측전간（ MTLE）치간구정측중적응용개치。방법대북경협화의원1997—2011년간89례MTLE병행수술치료급술후장기수진（≥2년）적환자술전발작록상진행회고성적분석，중점관주DP출현시간급기여치간구적측별관계。결과재89례MTLE환자공424차CPS중，유37례（41．6％）환자적공92차CPS중출현료DP。절대다수（92％） DP출현재발작중기，이불시발작적수발표현。 DP출현적대측다제시위치간구측，기정측치간구적양성예측치（ PPV）위93．9％。결론재MTLE중，DP시일충가고적정위체정，구유교고정측치간구개치。
Objective To explore the lateralizing value of dystonic posturing ( DP) of upper limb in patients with refractory mesial temporal lobe epilepsy ( MTLE ) .Methods Presurgical videotypes of 89 patients staying seizure-free for at least 2 years after temporal lobectomy were retrospectively reviewed. Attention was paid to temporal correlation between occurrence of DP and seizure and the relationship of DP to side of epileptogenic zone ( resected side) .Results DP was observed in 92 complex partial seizure ( CPS) from 37(41.6%)patients among 89 patients with a total of 424 CPS.DP was not an initial symptom in the course of CPS and its onset occurred mostly in the middle third of ictus.DP displayed a high positive predictive value of 93.9% for lateralizing a contralateral seizure onset.Conclusion DP is a reliable lateralizing sign in patients with MTLE.