Epilepsy Group, Department of Neurology, Braga Hospital, Largo Carlos Amarante, Apartado 2242, Braga 4701-965, Portugal.
J Clin Neurosci. 2011 May;18(5):593-600. doi: 10.1016/j.jocn.2010.08.018. Epub 2011 Feb 23.
About one-quarter of patients with refractory focal epilepsies have frontal lobe epilepsy (FLE). The typical seizure semiology for FLE includes unilateral clonic, tonic asymmetric or hypermotor seizures. Interictal electroencephalograms (EEG) usually reveal interictal epileptiform discharges and rhythmical midline theta, which has localizing value. The usefulness of ictal EEG recordings is limited by frequent muscle artifacts in motor seizures and because a large portion of the frontal lobe cortex is "hidden" to scalp electrodes. Ictal single photon emission CT and positron emission tomography are able to localize FLE in about one-third of patients only. A pre-surgical evaluation should include, whenever possible, a subclassification of FLE as dorsolateral frontal, mesial frontal or basal frontal lobe epilepsy to allow a minimal cortical resection. A review of the typical findings of seizure semiology, interictal and ictal EEG regarding the different FLE subtypes is given. Etiology, medical treatment and surgery are also discussed.
大约四分之一的耐药局灶性癫痫患者患有额叶癫痫（FLE）。FLE 的典型发作表现包括单侧阵挛性、强直性不对称或运动过度性发作。发作间期脑电图（EEG）通常显示发作间期癫痫样放电和节律性中线θ波，具有定位价值。发作期 EEG 记录的有用性受到运动性发作中频繁的肌肉伪影的限制，并且因为额叶皮层的很大一部分对于头皮电极来说是“隐藏的”。只有大约三分之一的患者能够通过发作期单光子发射 CT 和正电子发射断层扫描来定位 FLE。术前评估应尽可能包括将 FLE 进行亚分类为背外侧额叶、内侧额叶或基底额叶癫痫，以允许进行最小的皮质切除术。本文回顾了不同 FLE 亚型的发作表现、发作间期和发作期 EEG 的典型发现。还讨论了病因、药物治疗和手术治疗。
