Skidmore Christopher T
Continuum (Minneap Minn). 2016 Feb;22(1 Epilepsy):94-115. doi: 10.1212/CON.0000000000000290.
Focal epilepsy is the most common type of epilepsy in adulthood. This article discusses the seizure symptomatology, EEG findings, and imaging findings of the various forms of focal epilepsy. The majority of the article focuses on temporal and frontal lobe epilepsy as these represent the majority of focal epilepsies.
While significant overlap exists in the clinical symptomatology of the focal epilepsies, detailed seizure descriptions can often provide useful clinical evidence to help establish an accurate diagnosis. EEG and MRI continue to serve as the main diagnostic tools for the diagnosis of focal epilepsy.
The various forms of focal epilepsy generate seizure presentations that are dependent on the anatomic structures that are involved in the seizure. By understanding the symptoms typically generated in each region of the brain, a better understanding of the possible seizure localizations can be made. Most forms of epilepsy have clear changes on EEG that permit accurate localization, but several pitfalls exist, which are discussed in this article. Imaging has revolutionized our ability to accurately identify lesions associated with epilepsy and increased our ability to localize seizures in the brain.
局灶性癫痫是成人最常见的癫痫类型。本文讨论了各种形式局灶性癫痫的发作症状学、脑电图表现及影像学表现。文章大部分内容聚焦于颞叶和额叶癫痫,因为它们占局灶性癫痫的大部分。
虽然局灶性癫痫的临床症状学存在显著重叠,但详细的发作描述通常可提供有用的临床证据,有助于做出准确诊断。脑电图和磁共振成像仍是诊断局灶性癫痫的主要诊断工具。
各种形式的局灶性癫痫产生的发作表现取决于发作中涉及的解剖结构。通过了解大脑每个区域通常产生的症状,可以更好地理解可能的发作定位。大多数癫痫形式在脑电图上有明显变化,可实现准确定位,但也存在一些陷阱,本文将对此进行讨论。影像学彻底改变了我们准确识别与癫痫相关病变的能力,并提高了我们在大脑中定位癫痫发作的能力。