Young G Bryan, Blume Warren T
Department of Clinical Neurological Sciences, University of Western Ontario, London, Ontario, Canada.
Epilepsia. 2007 Mar;48(3):597-8. doi: 10.1111/j.1528-1167.2007.00979.x. Epub 2007 Feb 21.
Lateralized clonic jerks of the extremities during epileptic seizures usually arise from the contralateral rolandic cortex. In our exceptional case one-sided extremity twitches related to epileptiform activity in the ipsilateral frontal lobe.
Case study with clinical-electroencephalographic correlation.
A 47-year-old man suffered destruction of most of his right cerebral hemisphere, including the perirolandic region. Epilepsia partialis continua (EPC) ensued, with clonic jerks of the proximal right upper and lower limbs temporally related to periodic lateralized epileptiform discharges (PLEDs) from the parasagittal region of the right frontal lobe with a variable time interval over 100 ms. Sectioning of the subcortical callosal and projection connections of the frontal lobe abolished the clonic jerks.
We propose the ipsilateral EPC arose from projections from the supplementary motor region to the medullary reticular formation to account for the long and variable latency between PLEDs and jerks.
癫痫发作时肢体的偏侧阵挛性抽搐通常起源于对侧中央前回皮质。在我们这个特殊病例中，单侧肢体抽搐与同侧额叶的癫痫样活动有关。
进行临床-脑电图相关性的病例研究。
一名47岁男性右侧大脑半球大部分区域，包括中央前回周围区域遭到破坏。随后出现持续性部分性癫痫（EPC），右侧上肢和下肢近端的阵挛性抽搐在时间上与右侧额叶矢状旁区周期性一侧性癫痫样放电（PLEDs）相关，时间间隔超过100毫秒且变化不定。切断额叶的皮质下胼胝体和投射连接后，阵挛性抽搐消失。
我们提出同侧EPC起源于辅助运动区向延髓网状结构的投射，以解释PLEDs与抽搐之间较长且变化不定的潜伏期。
