Raymond A A, Fish D R, Stevens J M, Cook M J, Sisodiya S M, Shorvon S D
Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK.
Neurology. 1994 Oct;44(10):1841-5. doi: 10.1212/wnl.44.10.1841.
The possible dual occurrence of hippocampal sclerosis (HS) and other structural lesions (especially cortical dysgenesis [CD]) is well established in patients with chronic partial epilepsy. We describe the frequency of additional CD in a series of 100 patients with evidence of HS, using volumetric MRI. Additional, often subtle, CD was present in 15 patients: subependymal heterotopia (six), forme fruste of tuberous sclerosis (two), focal macrogyria (two), focal cortical dysplasia (one), laminar heterotopia (one), bilateral schizencephaly (one), and simplified gyral patterns (two). In contrast, in 46 healthy volunteers, only one had possible CD (p < 0.05). Only 2 of 15 patients had a history of childhood febrile convulsions. HS is a heterogeneous condition; patients being evaluated for temporal lobe surgery should be carefully screened for additional CD using appropriate MR techniques.
慢性部分性癫痫患者中，海马硬化（HS）与其他结构性病变（尤其是皮质发育异常[CD]）可能同时出现，这一点已得到充分证实。我们使用容积磁共振成像（MRI），描述了100例有HS证据的患者中额外CD的发生率。15例患者存在额外的、通常较为细微的CD：室管膜下异位（6例）、结节性硬化症的顿挫型（2例）、局灶性巨脑回（2例）、局灶性皮质发育不良（1例）、层状异位（1例）、双侧脑裂畸形（1例）以及简化脑回模式（2例）。相比之下，在46名健康志愿者中，只有1人可能存在CD（p < 0.05）。15例患者中只有2例有儿童期热性惊厥病史。HS是一种异质性疾病；对于接受颞叶手术评估的患者，应使用适当的MR技术仔细筛查是否存在额外的CD。
