Seethaler Magdalena, Lauseker Michael, Ernst Katharina, Rémi Jan, Vollmar Christian, Noachtar Soheyl, Kaufmann Elisabeth
Epilepsy Center, Department of Neurology, University Hospital, LMU Munich, Munich, Germany.
Department of Psychiatry and Psychotherapy, Charité University Medicine and St. Hedwig Hospital, Berlin, Germany.
Acta Neurol Scand. 2021 Mar;143(3):248-255. doi: 10.1111/ane.13356. Epub 2020 Oct 21.
To assess hemispheric differences in the duration of focal onset seizures and its association with clinical and demographic factors.
A retrospective analysis was performed on adult patients with drug-resistant unifocal epilepsy, who underwent intracranial EEG recording between 01/2006 and 06/2016. Seizure duration was determined based on the subdural and/or stereo-EEG (sEEG) recordings. Hemispheric differences in seizure duration were statistically evaluated with regard to clinical and demographic data.
In total, 69 patients and 654 focal onset seizures were included. The duration of seizures with left-hemispheric onset (n = 297) was by trend longer (91.88 ± 93.92 s) than of right-hemispheric seizures (n = 357; 71.03 ± 68.53 s; p = .193). Significant hemispheric differences in seizures duration were found in temporal lobe seizures (n = 225; p = .013), especially those with automotor manifestation (n = 156; p = .045). A prolonged duration was also found for left-hemispheric onset seizures with secondary generalized commencing during waking state (n = 225; p = .034), but not during sleep. A similar hemispheric difference in seizure duration was found in female patients (p = .040), but not in men.
Hemispheric differences in seizure duration were revealed with significantly longer durations in case of left-hemispheric seizure onset. The observed differences in seizure duration might result from brain asymmetry and add new aspects to the understanding of seizure propagation and termination.
评估局灶性发作癫痫持续时间的半球差异及其与临床和人口统计学因素的关联。
对2006年1月至2016年6月间接受颅内脑电图记录的耐药性单灶性癫痫成年患者进行回顾性分析。根据硬膜下和/或立体脑电图（sEEG）记录确定癫痫发作持续时间。对癫痫发作持续时间的半球差异进行临床和人口统计学数据的统计学评估。
共纳入69例患者和654次局灶性发作。左半球发作的癫痫持续时间（n = 297）有比右半球发作（n = 357；71.03 ± 68.53秒；p = 0.193）更长的趋势。在颞叶癫痫发作（n = 225；p = 0.013）中发现癫痫发作持续时间存在显著的半球差异，尤其是那些有自动运动表现的发作（n = 156；p = 0.045）。左半球发作且在清醒状态下继发全身性发作的癫痫持续时间也较长（n = 225；p = 0.034），但在睡眠期间则不然。在女性患者中也发现了类似的癫痫发作持续时间的半球差异（p = 0.040），但男性患者中未发现。
揭示了癫痫发作持续时间的半球差异，左半球癫痫发作时持续时间明显更长。观察到的癫痫发作持续时间差异可能源于脑不对称性，并为理解癫痫传播和终止增添了新的方面。
