MRI 正常颞叶癫痫的临床和电生理特征。

The clinical and electrophysiological characteristics of temporal lobe epilepsy with normal MRI.

机构信息

Department of Neurology, Inje University, Pusan Paik Hospital, Pusan, Korea.

出版信息

J Clin Neurol. 2006 Mar;2(1):42-50. doi: 10.3988/jcn.2006.2.1.42. Epub 2006 Mar 20.

DOI:10.3988/jcn.2006.2.1.42

PMID:20396484

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2854942/

Abstract

BACKGROUND AND PURPOSE

To identify the clinical and electrophysiological characteristics of temporal lobe epilepsy (TLE) with normal MRI.

METHODS

Twenty-six patients were diagnosed with TLE with normal MRI by stereotaxically implanted depth electrode EEG (SEEG) and quantitative MRI. We divided the patients into anterior or diffuse temporal groups by interictal EEG, into localized, hemispheric or non-lateralized onset groups by ictal scalp EEG, and into focal or regional onset groups by SEEG. The clinical and electrophysiological characteristics were compared with those of 25 TLE patients with unilateral hippocampal atrophy (HA) on MRI. Four patients of TLE with unilateral HA also underwent SEEG.

RESULTS

Patients in the normal MRI group showed a significantly higher frequency of secondarily generalization (225+/-235, median 160 vs 68+/-48, median 50, p<0.05), shorter duration of epilepsy (16+/-10 yrs vs 25.9+/-7.8 yrs, p<0.001), and less favorable surgical outcome (50% vs 88%, p <0.05) than patients in the unilateral HA group. Also, patients with normal MRI frequently showed diffuse temporal (50% vs 20%, p<0.05) discharges on interictal EEG. The ictal seizure patterns of patients with normal MRI showed less localization to one temporal lobe on scalp EEG (28% vs 65%, p<0.001) and a higher frequency of regional onset on SEEG (68% vs 8%, p<0.001) than patients with unilateral HA.

CONCLUSIONS

The characteristics of TLE with normal MRI compared with TLE with unilateral HA are shorter duration of epilepsy, higher frequency of secondarily generalization, and less favorable surgical outcome, suggesting wider areas of temporal lobe involved compared with patients with unilateral HA.

摘要

背景与目的

确定磁共振成像（MRI）正常的颞叶癫痫（TLE）的临床和电生理特征。

方法

通过立体定向植入深度电极脑电图（SEEG）和定量 MRI，对 26 例 MRI 正常的 TLE 患者进行诊断。我们根据发作间期 EEG 将患者分为前颞叶或弥散性颞叶组，根据发作期头皮 EEG 将患者分为局限性、半球性或非偏侧性起始组，根据 SEEG 将患者分为局灶性或区域性起始组。比较了这些患者与 25 例 MRI 单侧海马萎缩（HA）的 TLE 患者的临床和电生理特征。4 例 MRI 单侧 HA 的 TLE 患者也接受了 SEEG 检查。

结果

MRI 正常组患者继发全面性发作的频率明显更高（225+/-235，中位数 160 比 68+/-48，中位数 50，p<0.05），癫痫持续时间更短（16+/-10 年比 25.9+/-7.8 年，p<0.001），手术效果较差（50%比 88%，p<0.05），发作间期 EEG 显示弥漫性颞叶放电的患者也更常见（50%比 20%，p<0.05）。MRI 正常组患者的发作性癫痫样放电在头皮 EEG 上的局限性较小（28%比 65%，p<0.001），在 SEEG 上的区域性起始更常见（68%比 8%，p<0.001）。