Janszky J, Fogarasi A, Jokeit H, Ebner A
Epilepsie-Centrume Bethel, Mara Krankenhaus, Maraweg 21, Bielefeld 33617, Germany.
J Neurol Neurosurg Psychiatry. 2000 Aug;69(2):244-7. doi: 10.1136/jnnp.69.2.244.
The purpose was to analyse whether non-speech vocalisations in seizures originating in the frontal lobe do have lateralising value. Patients were included who had undergone presurgical evaluation with ictal video-EEG monitoring at the Epilepsy Centre, had had resective epilepsy surgery involving the frontal lobe, and who had remained seizure free>1 year postoperatively. Twenty seven patients aged 1-42 years (mean 18) met the inclusion criteria. Age at epilepsy onset ranged from 1 month to 41 years (mean 7.1 years). All selected patients had a unilateral MRI detected lesion within the frontal lobe. Fifteen patients had right sided, 12 patients had left sided epileptogenic zones. Seizures recorded during EEG-video monitoring were re-evaluated to identify the occurrence of ictal vocalisations. Pure ictal vocalisations were distinguished from ictal sound productions due to motor or vegetative seizure activity (for example, cloni or respiratory sounds). Pure ictal vocalisation occurred in 11 patients of whom nine had a left frontal epileptogenic zone (p<0.01). It is concluded that ictal vocalisation could be an additional lateralising sign in frontal lobe epilepsy. The results suggest that not only speech, but vocalisation at a subverbal level also shows a left hemispheric dominance in humans.
目的是分析起源于额叶的癫痫发作中的非言语发声是否具有定位价值。纳入的患者在癫痫中心接受了术前发作期视频脑电图监测，进行了涉及额叶的切除性癫痫手术，且术后1年以上无癫痫发作。27例年龄在1至42岁（平均18岁）的患者符合纳入标准。癫痫发作起始年龄范围为1个月至41岁（平均7.1岁）。所有入选患者在额叶均有单侧MRI检测到的病变。15例患者右侧有癫痫灶，12例患者左侧有癫痫灶。对脑电图视频监测期间记录的癫痫发作进行重新评估，以确定发作期发声的发生情况。将纯粹的发作期发声与由运动或自主神经癫痫活动引起的发作期声音产生（例如，阵挛或呼吸声）区分开来。11例患者出现纯粹的发作期发声，其中9例患者左侧额叶有癫痫灶（p<0.01）。结论是发作期发声可能是额叶癫痫的一个额外定位体征。结果表明，不仅言语，而且次言语水平的发声在人类中也表现出左半球优势。
