Department of Neurology, Medical School, Istanbul Medeniyet University, Istanbul, Turkey.
Int J Neurosci. 2024 Jun;134(3):224-228. doi: 10.1080/00207454.2022.2098736. Epub 2022 Jul 18.
The central nervous system is known to have asymmetric immune system modulation. Thus far, no clinical study has examined asymmetric immune modulation between hemispheres in focal epilepsy patients. We aimed to compare the prognosis of epilepsy patients lateralized to the right hemisphere with epilepsy patients lateralized to the left hemisphere using clinic and demographic data. Ninety-nine patients with focal epilepsy with all seizures originating in only one hemisphere, between the ages of 18-and 86 years were included. We included patients with focal epilepsy whose seizures were lateralized to only one hemisphere. Age, gender, marital status, education, mental retardation, hand dominance, etiology, trauma, central nervous system infection, febrile convulsion, parental relationships, seizure onset age, seizure frequency (per month), systemic disease, and biochemical parameters were recorded. To evaluate lateralization, we used positron emission tomography (PET/CT), long-term video-electroencephalography (EEG), and magnetic resonance imaging (MRI) investigations. Thirty-seven patients (37.4%) patients were right-lateralized, whereas 62 patients (62.6%) were left-lateralized ( = 0.01). Seizures frequency seizures were higher in patients lateralized to the left hemisphere than in the right. ( = 0.001). In patients with epilepsy lateralized to the left hemisphere, epilepsy onset age was lower ( = 0.003), numbers of antiepileptic medicines were higher ( = 0.04), and epilepsy durations and longest seizure-free periods were longer ( = 0.001 and = 0.04, respectively). We have shown that compared to the right hemisphere, the left hemisphere is far more prone to seizures and has a poorer prognosis.
中枢神经系统的免疫系统调节存在不对称性。迄今为止，尚无临床研究检查局灶性癫痫患者半球间的不对称免疫调节。我们旨在使用临床和人口统计学数据比较右侧和左侧局灶性癫痫患者的预后。纳入了 99 名单侧局灶性癫痫患者，所有发作均起源于单侧半球，年龄在 18 岁至 86 岁之间。我们纳入了发作仅局限于单侧半球的局灶性癫痫患者。记录了年龄、性别、婚姻状况、教育程度、智力障碍、手优势、病因、创伤、中枢神经系统感染、热性惊厥、父母关系、发作起始年龄、每月发作频率、全身性疾病和生化参数。为了评估偏侧化，我们使用正电子发射断层扫描（PET/CT）、长程视频脑电图（EEG）和磁共振成像（MRI）检查。37 名患者（37.4%）为右侧偏侧化，62 名患者（62.6%）为左侧偏侧化（ = 0.01）。左侧偏侧化患者的发作频率高于右侧偏侧化患者（ = 0.001）。左侧偏侧化癫痫患者的癫痫起始年龄较低（ = 0.003），抗癫痫药物的数量较高（ = 0.04），癫痫持续时间和最长无发作时间较长（ = 0.001 和 = 0.04，分别）。我们表明，与右侧半球相比，左侧半球更容易发生癫痫发作，预后较差。
