Schulz R, Lüders H O, Hoppe M, Jokeit H, Moch A, Tuxhorn I, May T, Ebner A
Abteilung für prächirurgische Epilepsiediagnostik, Epilepsiezentrum Mara gGmbH, Epilepsiezentrum Bethel, Maraweg 21, 33617, Bielefeld, Germany.
Epilepsy Res. 2001 Mar;43(3):201-10. doi: 10.1016/s0920-1211(00)00195-9.
The diagnostic value of lack of aura experience in patients with temporal lobe epilepsy (TLE) is unclear.
To evaluate possible factors of bitemporal dysfunction in patients with mesial TLE who did not experience an aura in electroencephalography EEG/video monitoring for epilepsy surgery.
Ictal scalp EEG propagation patterns of 347 seizures of 58 patients with mesial temporal lobe sclerosis or non-lesional mesial TLE, interictal epileptiform discharges (IED), presence of unilateral mesial temporal lobe sclerosis in visual magnetic resonance imaging (MRI) analysis, prose memory performance, history or not of an aura, and postictal memory or absence of an aura were analyzed. The ictal EEG was categorized as follows. EEG seizure: (a) remaining regionalized, (b) non-lateralized, (c) showing later switch of lateralization or bitemporal asynchronous ictal patterns.
Absent aura in monitoring was significantly correlated with absence of unitemporal MRI sclerosis (P=0.004), bitemporal IED (P=0.008), and propagation of the ictal EEG to the contralateral temporal lobe (P=0.001). Other historical data and interictal prose memory performance were not significantly correlated with absent aura. Ten of 11 patients without aura in monitoring also had absent or rare auras in their history.
Lack of aura experience strongly correlates with indicators of bitemporal dysfunction such as bitemporal interictal sharp waves and bitemporal ictal propagation in scalp EEG, and absence of lateralized MRI sclerosis in patients with mesial TLE. The fact that absent auras are not correlated with episodic memory suggests a transient memory deficit, probably because of rapid propagation to the contralateral mesial temporal lobe.
颞叶癫痫（TLE）患者缺乏先兆体验的诊断价值尚不清楚。
评估在癫痫手术的脑电图（EEG）/视频监测中未经历先兆的内侧颞叶癫痫（mTLE）患者双侧颞叶功能障碍的可能因素。
分析了58例内侧颞叶硬化或非病变性内侧TLE患者的347次发作的发作期头皮EEG传播模式、发作间期癫痫样放电（IED）、视觉磁共振成像（MRI）分析中单侧内侧颞叶硬化的存在情况、散文记忆表现、有无先兆病史以及发作后记忆或有无先兆。发作期EEG分类如下。EEG发作：（a）局限于局部，（b）无侧化，（c）显示侧化后期转换或双侧颞叶异步发作模式。
监测中无先兆与无单侧MRI硬化（P = 0.004）、双侧IED（P = 0.008）以及发作期EEG向对侧颞叶传播（P = 0.001）显著相关。其他病史数据和发作间期散文记忆表现与无先兆无显著相关性。监测中无先兆的11例患者中有10例在其病史中也无或很少有先兆。
缺乏先兆体验与双侧颞叶功能障碍指标密切相关，如头皮EEG中的双侧发作间期尖波和双侧发作期传播，以及内侧TLE患者无侧化MRI硬化。无先兆与情景记忆无关这一事实表明存在短暂的记忆缺陷，可能是由于快速传播至对侧内侧颞叶。
