Tsai Meng-Han, Hsu Shih-Pin, Huang Chi-Ren, Chang Chen-Sheng, Chuang Yao-Chung
Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Acta Neurol Taiwan. 2010 Jun;19(2):131-6.
Seizures originating in the occipital areas are relatively uncommon. They are usually characterized by visual hallucinations and illusions or other symptoms related to the eyes and vision.
In a 54-year-old woman with occipital lobe epilepsy, complex visual hallucinations, illusions, and migraine-like headache constitute the major clinical manifestations. During focal status epilepticus, ictal electroencephalography revealed rhythmic focal spikes in the right occipital region, rapidly propagating to the right parietal and contralateral occipital areas. Ictal brain single-photon emission computed topography revealed hyperperfusion of the right occipital region. Using a full-field pattern-shift visual evoked potential (VEP) study, we found that the P100 responses on both sides were markedly attenuated in amplitude during occipital focal status epilepticus, whereas the latencies of the VEPs were normal. The amplitude and morphology of P100 responses on both sides, however, returned to the normal range 7 days after cessation of the seizures.
In addition to clinical seizure semiology, scalp EEG, SPECT and neuroimaging studies, VEP studies may be used as a supplementary examination tool to provide further information in the patients with occipital lobe seizures or epilepsies.
起源于枕叶的癫痫发作相对少见。它们通常以视幻觉、错觉或其他与眼睛及视觉相关的症状为特征。
一名54岁枕叶癫痫女性患者，主要临床表现为复杂视幻觉、错觉和偏头痛样头痛。在局灶性癫痫持续状态期间，发作期脑电图显示右侧枕叶区域有节律性局灶性棘波，迅速扩散至右侧顶叶和对侧枕叶区域。发作期脑单光子发射计算机断层扫描显示右侧枕叶区域血流灌注增加。通过全视野模式翻转视觉诱发电位（VEP）研究，我们发现枕叶局灶性癫痫持续状态期间双侧P100波幅明显衰减，而VEP潜伏期正常。然而，癫痫发作停止7天后，双侧P100波幅和形态恢复至正常范围。
除临床发作症状学、头皮脑电图、单光子发射计算机断层扫描和神经影像学检查外，VEP研究可作为一种辅助检查手段，为枕叶癫痫发作或癫痫患者提供更多信息。
