Schindler Kaspar, Wieser Heinz Gregor
Department of Epileptology and EEG, University Hospital of Zürich, Frauenklinikstrasse 26, CH-8091 Zürich, Switzerland.
Epilepsy Behav. 2006 Feb;8(1):323-7. doi: 10.1016/j.yebeh.2005.10.014. Epub 2005 Dec 6.
Ictal vomiting in patients with focal epilepsy has mostly been associated with an epileptogenic zone in the non-language-dominant hemisphere. Here we present the case of a left hemisphere language-dominant patient suffering from typical mesial temporal lobe epilepsy with histologically proven hippocampal sclerosis and ictal vomiting during complex partial seizures. He became seizure-free after selective left-sided amygdalohippocampectomy. This case implies that ictal vomiting may not necessitate invasive electrophysiological exploration of left hemisphere language-dominant patients with temporal lobe epilepsy if surface EEG and MRI indicate a left-sided epileptogenic zone. It thus corroborates that with concordant imaging and neurophysiological data, clinical signs become less valuable.
局灶性癫痫患者的发作性呕吐大多与非语言优势半球的致痫区有关。在此，我们报告一例左侧半球语言优势的患者，患有典型的内侧颞叶癫痫，经组织学证实有海马硬化，在复杂部分性发作时有发作性呕吐。在选择性左侧杏仁核海马切除术之后，他不再发作。该病例表明，如果头皮脑电图和磁共振成像显示左侧有致痫区，对于左侧半球语言优势的颞叶癫痫患者，发作性呕吐可能无需进行侵入性电生理探查。因此证实，当影像学和神经生理学数据一致时，临床体征的价值就会降低。
