Kakisaka Yosuke, Nakasato Nobukazu, Haginoya Kazuhiro, Kanno Akitake, Tsuchiya Shigeru
Department of Pediatrics, Tohoku University School of Medicine, Sendai, Miyagi, Japan.
Epilepsy Res. 2009 Apr;84(2-3):153-8. doi: 10.1016/j.eplepsyres.2009.01.012. Epub 2009 Feb 28.
Benign childhood epilepsy with centro-temporal spikes (BECCT) is usually associated with anteriorly oriented rolandic discharges. We report an unusual type of childhood-onset epilepsy with sensorimotor seizures associated with posteriorly oriented rolandic discharges.
Among 942 patients who underwent simultaneous electroencephalography and magnetoencephalography (MEG) for epilepsy evaluation, we found 7 patients with sensorimotor seizures aged under 13 years at onset, with no abnormal magnetic resonance imaging findings, and posteriorly oriented rolandic discharges detected by MEG. Ictal and interictal symptoms were evaluated retrospectively.
All patients had rolandic seizures as well as atypical seizures, such as falling, head dropping, auditory hallucinations, postural symptoms and/or automatism. Seizures were medically intractable in 5 patients and well controlled in 2, one of whom had behavioral problems and the other had transient graphomotor impairment.
Posteriorly oriented rolandic discharges are better detected by MEG, and would exclude BECCT.
伴有中央颞区棘波的儿童良性癫痫（BECCT）通常与向前的中央沟放电有关。我们报告了一种不寻常的儿童期起病的癫痫，其伴有感觉运动性发作，并与向后的中央沟放电有关。
在942例因癫痫评估同时接受脑电图和脑磁图（MEG）检查的患者中，我们发现7例起病时年龄在13岁以下、有感觉运动性发作、磁共振成像无异常发现且MEG检测到向后的中央沟放电的患者。对发作期和发作间期症状进行回顾性评估。
所有患者均有中央沟发作以及非典型发作，如跌倒、头部下垂、幻听、姿势症状和/或自动症。5例患者的癫痫药物治疗无效，2例得到良好控制，其中1例有行为问题，另1例有短暂的书写运动障碍。
MEG能更好地检测到向后的中央沟放电，且可排除BECCT。
