颞叶癫痫发作后自动症的定侧价值

Lateralizing value of postictal automatisms in temporal lobe epilepsy.

作者信息

Rásonyi G, Fogarasi A, Kelemen A, Janszky J, Halász P

机构信息

Epilepsy Center, National Institute of Psychiatry and Neurology, Budapest, Hungary.

出版信息

Epilepsy Res. 2006 Aug;70(2-3):239-43. doi: 10.1016/j.eplepsyres.2006.05.006. Epub 2006 Jun 12.

DOI:10.1016/j.eplepsyres.2006.05.006

PMID:16765567

Abstract

PURPOSE

To describe clinical characteristics and lateralizing value of postictal automatisms in patients with temporal lobe epilepsy (TLE).

METHODS

One hundred and ninety-three videotaped seizures of 55 consecutive patients with refractory TLE and postoperatively seizure-free outcome were analyzed. Ictal as well as postictal (manual, oral and speech) automatisms were monitored.

RESULTS

Thirty-four (62%) of the 55 patients showed PA at least once during their seizures. Postictal automatism was observed in 70 (36%) attacks as manual (21%), oral (13%) or speech (9%) automatisms. Fifteen seizures contained a combination of two different postictal automatisms. The presence of postictal oral automatisms did not lateralize the seizure onset zone (p=0.834). Speech automatisms (repetitive verbal behavior) occurred more frequently after left-sided seizures (p=0.002). Postictal unilateral manual automatism showed no lateralizing value occurring by the ipsilateral hand in 10 and the contralateral upper limb in 6 seizures (p=0.454).

CONCLUSION

: Postictal automatism is a relatively frequent phenomenon in TLE. Postictal speech automatism lateralizes the seizure onset zone to the left hemisphere. Our observation can help the presurgical evaluation of TLE because verbal perseveration frequently occurs spontaneously, even in seizures without appropriate postictal language testing.

摘要

目的

描述颞叶癫痫（TLE）患者发作后自动症的临床特征及定位价值。

方法

分析55例难治性TLE且术后无癫痫发作患者的193次录像发作。监测发作期及发作后（手动、口腔和言语）自动症。

结果

55例患者中有34例（62%）在发作期间至少出现一次发作后自动症（PA）。在70次发作（36%）中观察到发作后自动症，表现为手动自动症（21%）、口腔自动症（13%）或言语自动症（9%）。15次发作包含两种不同发作后自动症的组合。发作后口腔自动症的存在不能确定发作起始区的位置（p = 0.834）。言语自动症（重复性言语行为）在左侧发作后更频繁出现（p = 0.002）。发作后单侧手动自动症无定位价值，同侧手出现10次，对侧上肢出现6次（p = 0.454）。