West S E, Doty R L
Department of Otorhinolaryngology, Head and Neck Surgery, University of Pennsylvania, Philadelphia, USA.
Epilepsia. 1995 Jun;36(6):531-42. doi: 10.1111/j.1528-1157.1995.tb02565.x.
Olfactory auras accompany some cases of epilepsy. Several aspects of olfactory function, including sensitivity, also may be altered. We reviewed the literature on these topics, as well as studies evaluating the influences of temporal lobe resection and other seizure management procedures on olfactory function. We concluded that: (a) despite several studies, the prevalence of olfactory auras in epilepsy is unknown, with estimates ranging from < 1% to > 30%; (b) epilepsy appears to cause a generalized decrease in olfactory functioning, although increased sensitivity may occur in some epileptic patients at some time in the preictal period; (c) other sensory modalities are also affected by the epileptic process which, in some cases, involve limbic-related temporal lobe structures; (d) many of the olfactory deficits previously attributed to temporal lobe resection actually exist preoperatively; (e) a taste/flavor confusion exists in the reporting of taste auras; (f) unpleasant auras are associated with hyperresponsiveness of neurons, which may explain why most epilepsy-related olfactory auras are described as "bad"; and (g) interesting parallels exist between the effects of the neuroendocrine system on seizure activity and olfactory function.
嗅觉先兆伴随部分癫痫病例出现。嗅觉功能的多个方面，包括敏感性，也可能发生改变。我们回顾了关于这些主题的文献，以及评估颞叶切除术和其他癫痫治疗手段对嗅觉功能影响的研究。我们得出以下结论：(a) 尽管有多项研究，但癫痫中嗅觉先兆的患病率尚不清楚，估计范围从<1%到>30%；(b) 癫痫似乎会导致嗅觉功能普遍下降，尽管在发作前期的某些时候，一些癫痫患者可能会出现敏感性增加；(c) 癫痫过程也会影响其他感觉模态，在某些情况下，涉及与边缘系统相关的颞叶结构；(d) 许多先前归因于颞叶切除术的嗅觉缺陷实际上在术前就已存在；(e) 在味觉先兆的报告中存在味觉/味道混淆；(f) 不愉快的先兆与神经元的高反应性有关，这可能解释了为什么大多数与癫痫相关的嗅觉先兆被描述为“难闻的”；(g) 神经内分泌系统对癫痫活动和嗅觉功能的影响之间存在有趣的相似之处。
