Kim Dong Wook, Lee Seo-Young, Lee Sang Kun
Department of Neurology, Konkuk University School of Medicine, Seoul, Korea.
Department of Neurology, Kangwon National University, Chuncheon, Korea.
J Epilepsy Res. 2016 Dec 31;6(2):75-78. doi: 10.14581/jer.16014. eCollection 2016 Dec.
There are reports of successful resective epilepsy surgery for pediatric patients with epilepsy and generalized epileptiform discharges when they had focal epileptogenic lesions identified by MRI. However, there is limited information regarding adult patients with epilepsy who have both generalized epileptiform discharges and focal epileptogenic lesions.
To investigate the incidence and characteristics of adult patients who have both generalized epileptiform discharges and potentially epileptogenic lesions, we retrospectively analyzed data of clinical features and results of EEG and MRI of all patients with adult-onset epilepsy in a tertiary referral hospital.
While 1315 patients were classified as having partial seizures, 207 patients were classified as having generalized seizures. Five of 207 patients (2.4%) with generalized seizures had potentially epileptogenic lesions. All the epileptogenic lesions were congenital or acquired during early life, such as focal cortical dysplasia, dysembryoplastic neuroepithelial tumor, and cerebromalacic change because of perinatal injury.
The presence of epileptogenic lesions in adult patients with generalized epileptiform discharges may be an incidental finding, but it has been suggested that some adult-onset epilepsy with generalized epileptiform discharges may actually have focal onset, which may have significant clinical implications for the choice of appropriate treatment.
有报道称，患有癫痫且有广泛性癫痫样放电的儿科患者，当通过MRI发现局灶性致痫病灶时，进行切除性癫痫手术取得了成功。然而，关于患有广泛性癫痫样放电和局灶性致痫病灶的成年癫痫患者的信息有限。
为了调查患有广泛性癫痫样放电和潜在致痫病灶的成年患者的发病率及特征，我们回顾性分析了一家三级转诊医院中所有成年起病癫痫患者的临床特征数据以及脑电图（EEG）和磁共振成像（MRI）结果。
1315例患者被归类为部分性发作，207例患者被归类为全身性发作。207例全身性发作患者中有5例（2.4%）存在潜在致痫病灶。所有致痫病灶均为先天性或早年获得性，如局灶性皮质发育不良、胚胎发育不良性神经上皮肿瘤以及围产期损伤所致的脑软化改变。
患有广泛性癫痫样放电的成年患者中存在致痫病灶可能是一个偶然发现，但有人提出，一些伴有广泛性癫痫样放电的成年起病癫痫实际上可能是局灶性起病，这对于选择合适的治疗方法可能具有重要的临床意义。
