Fernández Torre J L
Departamento de Neurofisiología Clínica, King's College Hospital, Denmark Hill, Londres, Reino Unido.
Neurologia. 1999 Jan;14(1):29-34.
To review signs and symptoms associated with temporal complex partial seizures (CPS) and their utility in the localization and lateralization of seizure onset.
CPS are particularly resistant to the standard antiepileptic drugs. Since surgical treatment is a therapeutical alternative in patients with intractable seizures, localization and lateralization of seizure origin are the principal aims in the preoperative assessment. Video-EEG monitorization has made possible characterization of ictal behaviour and correlation with cerebral regions generating the epileptic discharge. Therefore, ictal semiology has increased its importance in the localization and lateralization of seizures. The utility of auras, automatisms, motor manifestations, speech disturbances and autonomic features have been reviewed in relation to this approach.
Viscerosensorial and experiential auras have been associated with temporal lobe epilepsy. The automatisms are not exclusive of temporal seizures and may be observed in frontal epilepsy and parietal and occipital seizures with spreading to temporal structures. There is not agreement in relation to head turning and version, therefore, this clinical sign should be used in correlation to other clinical manifestations. Distonic posturing, comprehensible ictal speech and postictal dysphasia appear to be the most reliable clinical signs in the lateralisation of temporal lobe seizures.
回顾与颞叶复杂部分性发作（CPS）相关的体征和症状及其在癫痫发作起始部位定位和定侧中的作用。
CPS对标准抗癫痫药物具有特别的耐药性。由于手术治疗是难治性癫痫患者的一种治疗选择，癫痫发作起源的定位和定侧是术前评估的主要目标。视频脑电图监测使发作期行为的特征描述以及与产生癫痫放电的脑区的相关性分析成为可能。因此，发作期症状学在癫痫发作的定位和定侧中变得更加重要。已就先兆、自动症、运动表现、言语障碍和自主神经特征在该方法中的作用进行了综述。
内脏感觉性和体验性先兆与颞叶癫痫有关。自动症并非颞叶癫痫所特有，在额叶癫痫以及扩散至颞叶结构的顶叶和枕叶癫痫中也可观察到。关于头转向和眼偏斜，目前尚无定论，因此，该临床体征应与其他临床表现相关联使用。张力障碍姿势、可理解的发作期言语和发作后失语似乎是颞叶癫痫定侧中最可靠的临床体征。
