Oestreich L J, Berg M J, Bachmann D L, Burchfiel J, Erba G
Comprehensive Epilepsy Program, University of Rochester Medical Center, New York 14642, USA.
Epilepsia. 1995 Jul;36(7):671-5. doi: 10.1111/j.1528-1157.1995.tb01044.x.
Certain behaviors that occur during a complex partial seizure (CPS) are useful in lateralizing the side of seizure onset. In 5 (5.3%) of 94 consecutive patients with partial epilepsy, we observed ictal unilateral arm and hand paresis during 27 of 34 CPS. In all these seizures, this behavior occurred contralateral to an epileptogenic temporal lobe, as determined by video-EEG monitoring and surgical outcome. In 5 of the 27 seizures, an observer demonstrated that the paretic arm and hand were flaccid. None of these patients had postictal (Todd's) paralysis. In most of the seizures, the arm ipsilateral to seizure onset had simultaneous purposeful movements or automatisms, sometimes with awkward posturing. Ictal unilateral paresis is distinctly different from ictal dystonia or postictal paralysis and consistently lateralizes seizure onset to the contralateral temporal lobe. Recognition of this particular ictal behavior and comparison to other simultaneous behaviors can aid in the lateralization and possibly localization of the epileptogenic zone.
复杂部分性发作（CPS）期间出现的某些行为有助于确定癫痫发作起始的侧别。在94例连续性部分性癫痫患者中，有5例（5.3%）在34次CPS中的27次发作期间出现发作期单侧手臂和手部轻瘫。在所有这些发作中，根据视频脑电图监测和手术结果判定，这种行为发生在致痫颞叶的对侧。在27次发作中的5次发作中，一名观察者发现麻痹的手臂和手部呈弛缓状态。这些患者均无发作后（托德氏）麻痹。在大多数发作中，发作起始同侧的手臂同时出现有目的的运动或自动症，有时伴有姿势异常。发作期单侧轻瘫明显不同于发作期肌张力障碍或发作后麻痹，且始终将癫痫发作起始侧别定位于对侧颞叶。识别这种特殊的发作期行为并与其他同时出现的行为进行比较，有助于癫痫源区的侧别判断，甚至可能有助于其定位。
