Geyer J D, Payne T A, Faught E, Drury I
Department of Neurology, University of Michigan, Ann Arbor, USA.
Neurology. 1999 Mar 10;52(4):743-5. doi: 10.1212/wnl.52.4.743.
Semiology is very useful in the diagnosis and classification of seizures. Some clinical signs occur primarily with specific localization-related epilepsies.
To evaluate postictal nose-rubbing as a potential diagnostic sign and a potential lateralizing or localizing indicator.
We reviewed presurgical prolonged video-EEG results of 50 consecutive patients with right temporal lobe epilepsy (TLE), 50 consecutive patients with left TLE, 50 consecutive patients with frontal lobe epilepsy, 11 consecutive patients with generalized epilepsy, and 100 consecutive patients with nonepileptic events. Videotapes of all events were reviewed independently by two investigators who were blinded to the results of the monitoring. The episodes of nose-rubbing and the hand with which the patient rubbed the nose were recorded.
Nose-rubbing occurred in 25 of 50 (50%) right TLE patients and in 21 of 50 (42%) left TLE patients. Approximately 90% of patients rubbed his or her nose with the ipsilateral hand. Nose-rubbing occurred in 5 of 50 (10%) frontal lobe epilepsy patients. Nose-rubbing was not seen in any patient with generalized epilepsy or nonepileptic events. Postictal nose-rubbing did not occur after secondarily generalized seizures.
Nose-rubbing is an easily observed phenomenon, has high interobserver reliability, and provides useful lateralizing information in patients with TLE. It was less frequently seen in extratemporal lobe epilepsy and was not seen after generalized seizures or nonepileptic events.
症状学在癫痫的诊断和分类中非常有用。一些临床体征主要出现在特定的与定位相关的癫痫中。
评估发作后擦鼻作为一种潜在的诊断体征以及一种潜在的定侧或定位指标。
我们回顾了50例连续的右侧颞叶癫痫（TLE）患者、50例连续的左侧TLE患者、50例连续的额叶癫痫患者、11例连续的全身性癫痫患者以及100例连续的非癫痫事件患者的术前长时间视频脑电图结果。两名对监测结果不知情的研究人员独立审查了所有事件的录像带。记录擦鼻发作情况以及患者擦鼻所用的手。
50例右侧TLE患者中有25例（50%）出现擦鼻，50例左侧TLE患者中有21例（42%）出现擦鼻。约90%的患者用同侧手擦鼻。50例额叶癫痫患者中有5例（10%）出现擦鼻。在任何全身性癫痫患者或非癫痫事件患者中均未观察到擦鼻。继发全身性发作后未出现发作后擦鼻。
擦鼻是一种易于观察的现象，观察者间可靠性高，可为TLE患者提供有用的定侧信息。在颞叶外癫痫中较少见，在全身性发作或非癫痫事件后未出现。
