Inoyama Katherine, Devinsky Orrin
Department of Neurology, New York University School of Medicine, New York, NY, United States.
Department of Neurology, New York University School of Medicine, New York, NY, United States.
Handb Clin Neurol. 2019;166:341-353. doi: 10.1016/B978-0-444-64196-0.00019-4.
Cingulate epilepsy manifests with a broad range of semiologic features and seizure types. Key clinical features may elucidate ictal involvement of certain subregions of the cingulate gyrus. Ictal and interictal electroencephalogram findings in cingulate epilepsy vary and are often poorly localized, adding to the diagnostic challenge of identifying the seizure onset zone for presurgical cases, particularly in the absence of a lesion on imaging. Recent advances in multimodal imaging techniques may contribute to ictal localization and further our understanding of neural and epileptic pathways involving the cingulate gyrus. Beyond medication and surgical resection, new techniques including stereotactic laser ablation, responsive neurostimulation, and deep brain stimulation offer additional approaches for the treatment of cingulate epilepsy.
扣带回癫痫表现出广泛的症状学特征和发作类型。关键临床特征可能有助于阐明扣带回某些亚区域的发作期受累情况。扣带回癫痫的发作期和发作间期脑电图表现各异,且往往定位不佳,这增加了为术前病例确定癫痫发作起始区的诊断挑战,尤其是在影像学上未发现病变的情况下。多模态成像技术的最新进展可能有助于发作期定位,并加深我们对涉及扣带回的神经和癫痫通路的理解。除了药物治疗和手术切除外,包括立体定向激光消融、反应性神经刺激和深部脑刺激在内的新技术为扣带回癫痫的治疗提供了更多方法。