Vercueil Laurent, Hirsch Edouard
Neurology, CHU Grenoble, 38043 Grenoble Cedex 9, France.
Epileptic Disord. 2002 Dec;4 Suppl 3:S47-54.
This article attempts an overview of the clinical and electrophysiological evidence supporting the involvement of the basal ganglia in epileptic seizures. In contrast to animal data, evidence for a role of these structures in human epilepsies is lacking. However, from the theoretical point of view, it remains conceivable that, given their strong interconnectivity, basal ganglia could be functionally linked to the cerebral cortex during an epileptic seizure. Several clinical ictal aspects have been suggested to be compatible with the involvement of basal ganglia, namely, ictal dystonic posturing during temporal lobe seizures, rotatory seizures and paroxysmal dyskinesia-like seizures. On the other hand, basal ganglia dysfunction may also influence some aspects of epilepsy, as suggested by pure basal ganglia pathology such as Parkinson's disease, or the described effect of an acute basal ganglia lesion in epileptic patients. The data discussed in this review may stimulate further research to link basic scientific data to human epilepsies, and lead to the development of novel therapeutical solutions.
本文试图概述支持基底神经节参与癫痫发作的临床和电生理证据。与动物数据不同,缺乏这些结构在人类癫痫中起作用的证据。然而,从理论角度来看,鉴于其强大的相互连接性,在癫痫发作期间基底神经节仍有可能在功能上与大脑皮层相联系。有人提出几个临床发作期方面与基底神经节的参与相符,即颞叶癫痫发作时的发作性肌张力障碍姿势、旋转性发作和阵发性运动障碍样发作。另一方面,正如帕金森病等单纯基底神经节病变或癫痫患者急性基底神经节病变所描述的效应所表明的那样,基底神经节功能障碍也可能影响癫痫的某些方面。本综述中讨论的数据可能会刺激进一步的研究,将基础科学数据与人类癫痫联系起来,并导致新治疗方案的开发。