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记录了边缘系统发作的深度和精神病理学。

Depth recorded limbic seizures and psychopathology.

作者信息

Wieser H G

出版信息

Neurosci Biobehav Rev. 1983 Fall;7(3):427-40. doi: 10.1016/0149-7634(83)90050-7.

Abstract

Chronically performed stereotaxic depth recordings in medically intractable epileptics offer a unique chance to study the correlation of epileptic discharges with changes of higher mental functions as well as behavioral and emotional alterations. From a quantitative study using 213 complex partial seizures from 29 selected patients with partial drug resistant epilepsy and from the observation of other patients with well defined epileptic perturbations of the limbic system and related sensory brain areas a good correlation between ictal signs and chronotopographical seizure patterns was obtained. The special role of mesiobasal limbic structures, i.e., amygdala and hippocampus, and its connections to hypothalamic and frontobasal-cingulate areas is highlighted by tracing the seizures. It is concluded that besides the short-lived ictal abberations of mental state and emotional sphere ("psychical seizures") also some of the more prolonged behavior and personality changes seen frequently in patients with bitemporal basal spike foci might be attributed to narrowly confined limbic seizure discharges or to a "limbic dyscontrol syndrome" based on the altered activity of limbic structures due to the spike foci.

摘要

对药物治疗无效的癫痫患者进行长期立体定向深度记录,为研究癫痫放电与高级心理功能变化以及行为和情绪改变之间的相关性提供了独特的机会。通过对29例选定的部分耐药性癫痫患者的213次复杂部分性发作进行定量研究,并观察其他边缘系统和相关感觉脑区有明确癫痫扰动的患者,发现发作体征与发作时间-部位性发作模式之间存在良好的相关性。通过追踪癫痫发作突出了内侧基底边缘结构,即杏仁核和海马体,及其与下丘脑和额基底-扣带回区域的连接的特殊作用。得出的结论是,除了精神状态和情感领域短暂的发作期异常(“精神性发作”)外,双颞叶基底棘波灶患者中常见的一些持续时间较长的行为和人格变化,可能归因于局限于边缘系统的癫痫发作放电,或归因于基于棘波灶导致的边缘结构活动改变的“边缘系统失控综合征”。

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