Hacettepe University, School of Medicine, Department of Neurology, Ankara, Turkey; Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
Hacettepe University, School of Medicine, Department of Neurology, Ankara, Turkey.
J Clin Neurosci. 2019 Nov;69:51-54. doi: 10.1016/j.jocn.2019.08.038. Epub 2019 Aug 19.
Lower limb automatism has not been known well in temporal lobe epilepsy (TLE) patients. This study investigated the distribution of risk factors, EEG features, and pathology types in surgically treated TLE patients. We also made a comparison of this group to surgically treated TLE patients with isolated hand automatism. Twenty TLE patients with lower limb automatism (Group 1) and 20 TLE patients with isolated hand automatisms (Group 2) of similar age/sex distribution were enrolled in our study. Male/female ratio was 14/6 in both groups. Demographical characteristics, risk factors, pathology types and EEG features were compared between two groups. 15 and 8 patients out of Group 1 (75%) and Group 2 (40%) respectively, were undergone right-sided surgery. Ipsilateral lower limb automatism was seen in 80% of patients. The age of epilepsy onset was earlier in patients with lower limb automatism (p = 0.02). There was no significant difference between the groups in terms of the risk factors and other demographical characteristics. Although, EEG features were not different, onset of ictal EEG changes in the first 10 seconds were seen less frequently in Group 1(6 vs 9 patients) (p = 0.31). Hippocampal sclerosis as a pathology type was detected in 11 patients (55%) of Group 1, whereas in 16 patients (80%) of Group 2. TLE patients with lower limb automatism have an earlier age of epilepsy onset and the onset of ictal EEG changed in the first 10 seconds of clinical seizure and pure HS pathology was rarer than in TLE patients with hand automatisms. Further studies are needed to shed more light on the pathophysiology of lower extremity automatisms in TLE patients.
下肢自动症在颞叶癫痫（TLE）患者中并不常见。本研究调查了手术治疗的 TLE 患者中风险因素、脑电图特征和病理类型的分布。我们还将这组患者与手术治疗的仅有手部自动症的 TLE 患者进行了比较。我们纳入了 20 例有下肢自动症的 TLE 患者（第 1 组）和 20 例有孤立性手部自动症的 TLE 患者（第 2 组），两组患者的年龄/性别分布相似。两组患者中男性/女性比例分别为 14/6。比较两组患者的人口统计学特征、风险因素、病理类型和脑电图特征。第 1 组（75%）和第 2 组（40%）各有 15 例和 8 例患者接受了右侧手术。80%的患者出现同侧下肢自动症。下肢自动症患者的癫痫发病年龄较早（p=0.02）。两组患者在风险因素和其他人口统计学特征方面无显著差异。尽管脑电图特征无差异，但第 1 组（6 例 vs 9 例）患者的起始 10 秒内出现癫痫样脑电图改变的患者较少（p=0.31）。第 1 组中有 11 例（55%）患者存在海马硬化作为病理类型，而第 2 组中有 16 例（80%）患者存在海马硬化。下肢自动症的 TLE 患者癫痫发病年龄较早，临床发作起始 10 秒内癫痫样脑电图改变，单纯 HS 病理类型较 TLE 患者手部自动症患者更为少见。需要进一步研究以阐明 TLE 患者下肢自动症的病理生理学。
