Abstract: Objective To explore the symptomatogenic zone of hand automatisms in mesial temporal lobe epilepsy. Methods Seventy-nine patients with mesial temporal lobe epilepsy were retrospectively analyzed.According to the occurrence of hand automatism and involved side,they were divided into three groups:unilateral hand automatism group (HAU),bilateral hand automatism group (HAB) and no hand automatism group (NH).The cortical thickness based on surface-based morphometry (SBM) was used for analysis.Three groups of patients were compared with healthy control group. Results In both HAU and HAB groups,bilateral Rolandic area,supplementary motor area (SMA) and middle cingulate gyrus (MCC) were involved.In NH group,only bilateral Rolandic area involvement was found. Conclusion The symptomatogenic zone of hand automatism is located in bilateral SMA and MCC.Dystonia often occurs in the contralateral side of unilateral automatism,which may be the reason for more extensive brain involvement in unilateral automatism.

Key words: Temporal lobe epilepsy, Surface morphology analysis, Hand automatism, Symptomatogenic zone

摘要： 目的 探讨颞叶内侧型癫痫中手自动症的症状起始区。方法 回顾性分析79例颞叶内侧型癫痫患者,根据是否存在手自动症以及手自动症累及单手还是双手分为三组,单侧手自动症组(HAU),双侧手自动症组(HAB)和无手自动症组(NH)。通过脑表面形态学分析的方法以皮质厚度为分析指标。三组病人分别和健康对照组作比较。结果 HAU和HAB两组皮质变薄区域都累及双侧的中央区、辅助运动区(SMA)和中扣带回(MCC)。NH组只发现双侧中央区受累。结论 手自动症产生的症状起始区位于双侧SMA和MCC。单侧手自动症时对侧常合并肌张力障碍可能是导致单侧自动症组累及的脑区更加广泛的原因。

关键词: 颞叶癫痫, 表面形态学分析, 手自动症, 症状起始区