Aykac Seyma Ciftci, Ekinci Aysen Suzen, Tabakoglu Aycin Yıldız, Gulluoglu Halil, Aydogdu Ibrahim, Bademkıran Fikret, Uludag Burhanettin, Arac Nilgün, Guler Ayse
Neurology Department, Ege University Faculty Of Medicine, Izmir, Turkey.
Neurology Department, Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey.
Seizure. 2022 Oct;101:184-189. doi: 10.1016/j.seizure.2022.08.005. Epub 2022 Aug 23.
This study aims to determine the clinical significance of epileptic nystagmus in patients with acute neurological symptoms.
The clinical findings of patients with documented epileptic nystagmus, their original video and EEG data, and cranial imaging and laboratory tests were analyzed retrospectively.
20 patients were included in the study and 21 epileptic nystagmus attacks were determined from patients' clinical and video-EEG recordings. All recorded seizures with epileptic nystagmus were focal onset in nature. The ictal discharge pattern was rhythmic fast activity with a mean frequency of 15 Hz. The ictal discharges originated from the parieto-occipital (n = 8), temporo-occipital (n = 7), parieto-occipito-temporal (n = 3), temporal (n = 2), occipital (n = 1), and centroparietal (n = 1) areas. In the fast phase, the nystagmus was beating away from the side of ictal discharges. The origin of the ictal discharges on EEG images was compatible with the lesion localization at cranial MRI in all patients. Etiologies were epilepsy in seven patients, non-ketotic hyperglycemia in four, ketotic hyperglycemia in one, PRES in three, acute stroke in three, HSV encephalitis in one, and MELAS in one.
Epileptic nystagmus represents a guide to the lateralization and localization of the lesion in cases presenting with acute neurological symptoms. In these patients, the lesion is frequently in the posterior regions of the hemispheres. Although various diseases affect these regions in terms of etiology, such cases should be evaluated in terms of the presence of hyperglycemia.
本研究旨在确定急性神经症状患者中癫痫性眼球震颤的临床意义。
回顾性分析有记录的癫痫性眼球震颤患者的临床发现、原始视频和脑电图数据，以及头颅影像学和实验室检查结果。
本研究纳入20例患者，从患者的临床和视频脑电图记录中确定了21次癫痫性眼球震颤发作。所有记录的伴有癫痫性眼球震颤的发作本质上均为局灶性发作。发作期放电模式为节律性快活动，平均频率为15赫兹。发作期放电起源于顶枕部（n = 8）、颞枕部（n = 7）、顶枕颞部（n = 3）、颞部（n = 2）、枕部（n = 1）和中央顶叶（n = 1）区域。在快相期，眼球震颤背离发作期放电的一侧摆动。所有患者脑电图图像上发作期放电的起源与头颅MRI上的病变定位相符。病因包括7例癫痫、4例非酮症高血糖、1例酮症高血糖、3例 PRES、3例急性卒中、1例单纯疱疹病毒性脑炎和1例线粒体脑肌病伴乳酸血症和卒中样发作（MELAS）。
癫痫性眼球震颤可为急性神经症状患者的病变侧别和定位提供线索。在这些患者中，病变常位于半球后部。尽管病因方面有多种疾病累及这些区域，但此类病例应评估是否存在高血糖情况。
