Roodakker Kenney Roy, Ezra Bisrat, Gauffin Helena, Latini Francesco, Zetterling Maria, Berntsson Shala, Landtblom Anne-Marie
Department of Neuroscience, Neurology, Uppsala University, University Hospital, Uppsala, Sweden.
Department of Neurology and Department of Biomedical and Clinical Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden.
Epilepsy Behav Rep. 2020 Nov 5;16:100400. doi: 10.1016/j.ebr.2020.100400. eCollection 2021.
Ecstatic seizures constitute a rare form of epilepsy, and the semiology is diverse. Previously, brain areas including the temporal lobe and the insula have been identified to be involved in clinical expression. The aim of this report is to review changes in ecstatic seizures in a patient before and after operation for a hypothalamic hamartoma, and to scrutinize the relation to gelastic seizures. In this case, the ecstatic seizures disappeared after surgery of the hamartoma but reappeared eleven years later. Clinical information was retrospectively obtained from medical records, interviews, and a questionnaire covering seizure semiology that pertained to ecstatic and gelastic seizures. Our findings imply a possible connection between gelastic and ecstatic seizures, originating from a hypothalamic hamartoma. To our knowledge, this location has not previously been described in ecstatic seizures. Gelastic seizures may in this case be associated with ecstatic seizures. We speculate that patients with ecstatic seizures may have an ictal activation of neuronal networks that involve the insula. Our case may add information to the knowledge concerning ecstatic seizures.
狂喜性癫痫发作是一种罕见的癫痫形式，其症状学表现多样。此前，已确定包括颞叶和脑岛在内的脑区参与其临床表现。本报告的目的是回顾一名下丘脑错构瘤患者手术前后狂喜性癫痫发作的变化，并审视其与痴笑性癫痫发作的关系。在该病例中，错构瘤手术后狂喜性癫痫发作消失，但11年后再次出现。通过回顾病历、访谈以及一份涵盖与狂喜性和痴笑性癫痫发作相关的癫痫发作症状学的问卷，回顾性获取临床信息。我们的研究结果表明，痴笑性和狂喜性癫痫发作之间可能存在联系，其起源于下丘脑错构瘤。据我们所知，此前在狂喜性癫痫发作中尚未描述过这个部位。在该病例中，痴笑性癫痫发作可能与狂喜性癫痫发作相关。我们推测，狂喜性癫痫发作的患者可能存在涉及脑岛的神经元网络的发作期激活。我们的病例可能会为有关狂喜性癫痫发作的知识增添信息。
