Malone Stephen, Miller Ian, Jakayar Prasanna, Resnick Trevor, Bhatia Sanjiv, Duchowny Michael
Brain Institute and Comprehensive Epilepsy Program, Miami Children's Hospital, FL, USA.
Epileptic Disord. 2008 Dec;10(4):349-55. doi: 10.1684/epd.2008.0224.
The pre-operative assessment and surgical management of children and young adults with MRI-negative, frontal lobe epilepsy is often challenging owing to the semiologic expression being unusual or non-lateralizing. Localization based on functional tests may be non-convergent, further compounding the difficulty of surgical planning. We describe a patient with seizures presenting with early, subjective akinesia of the dominant hand that were at times triggered by repetitive motor tasks. Subdural EEG monitoring revealed seizure-origin in the ipsilateral dorsolateral frontal lobe. After resective surgery the patient has had a seizure free period of 9 months, and is free of deficits. This is the first report of frontal lobe seizure semiology consisting of ipsilateral ictal akinesia.
对于磁共振成像（MRI）阴性的儿童和青年额叶癫痫患者，术前评估和手术管理往往具有挑战性，因为其症状学表现不寻常或无定侧性。基于功能测试的定位可能不一致，这进一步增加了手术规划的难度。我们描述了一名患者，其癫痫发作表现为优势手早期主观运动不能，有时由重复性运动任务诱发。硬膜下脑电图监测显示癫痫起源于同侧背外侧额叶。切除性手术后，患者已无癫痫发作9个月，且无功能缺损。这是首例关于额叶癫痫症状学表现为同侧发作性运动不能的报告。
