假性颞叶癫痫电-临床特征及长期手术疗效

doi:10.19854/j.cnki.1008-2425.2022.05.0003

摘要/Abstract

摘要： 目的探讨假性颞叶癫痫患者的电-临床特征及手术后的长期发作控制疗效。方法回顾性分析我中心2012年1月至2018年12月收治的假性颞叶癫痫患者(PTLE组)的临床及术后随访资料,并与同期手术治疗的其他病变性局灶颞叶外癫痫患者(eTLE组)进行比较。结果共纳入PTLE患者18例,占13.5%(18/133)。18例PTLE患者MRI病变分布为:枕叶7例、顶叶7例、额叶3例及岛叶1例。脑电图间期癫痫样放电分布为:同侧颞区8例、双侧颞区8例及正常2例。发作期脑电表现为:同侧颞区起源11例、起源不清但中期同侧颞区放电优势6例及对侧颞区起源1例。PTLE组患者平均起病年龄为14.0±6.4岁,晚于eTLE组(12.2±12.7岁,P=0.026)。两组患者在病程、性别、热惊厥史、颅内脑电监测及手术侧别间无统计学差异。平均随访6.2±2.1年,PTLE组疗效为Engel Ⅰ级10例、Engel Ⅱ-Ⅳ级5例、失随访3例,和同期eTLE组疗效无统计学差异(P=0.517)。结论 PTLE最常见于顶枕区,起病年龄稍晚于其他eTLE患者,虽然具有颞叶癫痫相似的电-临床特征,仅切除颞叶外的致痫灶,可获得很好的长期发作控制疗效(不亚于其他eTLE患者)。

关键词: 假性颞叶癫痫, 脑电图, 起病年龄, 手术疗效

Abstract: Objective To investigate the electro-clinical characteristics and long-term surgical outcome in patients with pseudotemporal lobe epilepsy(PTLE).Methods The clinical and postoperative follow-up data of 18 patients with PTLE(PTLE group) admitted to our epilepsy center from January 2012 to December 2018 were retrospectively analyzed and compared with other lesional extratemporal lobe epilepsy(eTLE group)patientswho underwent surgical treatment during the same period.Results A total of 18 patients with PTLE were included,accounting for 13.5%(18/133).The distribution of MRI lesions in the 18 PTLE patients was:7 were located in occipital lobe,7 in parietal,3 in frontal,and 1 in insular lobe.The distribution of interictal epileptiform discharges was:ipsilateral temporal region in 8 cases,bilateral temporal region in 8 and normal in 2.The ictal EEG patterns were:ipsilateral temporal origin in 11 cases,unclear origin but discharges were mainly located in the ipsilateral temporalregion in the middle term in 6 cases and contralateral temporal origin in 1 case.The mean age of onset in the PTLE group was 14.0±6.4 years,which was later than that in the eTLE group(12.2±12.7 years,P=0.026).There were no statistical differences between the two groups in terms of duration,gender,history of febrile convulsions,intracranial EEG monitoring and surgical side.With a mean follow-up of 6.2±2.1 years,the outcome of the PTLE group was Engel class I in 10 cases,Engel class II-IV in 5 cases,and lost to follow-up in 3 cases,which was not statistically different from that of the eTLE group during the same period(P=0.517).Conclusion PTLE is most commonly seen in the parieto-occipital region,with a slightly later age of onset than other eTLE patients,although with similar electrical-clinical features of TLE,resection of only extratemporal epileptogenic foci can result in good long-term surgical outcomes(no worse outcome than other eTLE patients).

Key words: Pseudotemporal lobe epilepsy, EEG, Age of onset, Surgical outcome

中图分类号:

R742.1

马炜, 张伟, 陈隆, 高立. 假性颞叶癫痫电-临床特征及长期手术疗效[J]. 立体定向和功能性神经外科杂志, 2022, 35(5): 269-272.

Ma Wei, Zhang Wei, Chen Long, et al. Electro-clinical characteristics and long-term surgical outcome of pseudotemporal lobe epilepsy[J]. Chinese Journal of Stereotactic and Functional Neurosurgery, 2022, 35(5): 269-272.

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