Adachi N, Onuma T, Arima K, Kato M, Ishida S, Hisano T
National Center Hospital for Mental, Nervous and Muscular Disorders, National Center of Neurology and Psychiatry, Tokyo, Japan.
Seizure. 1997 Feb;6(1):73-9. doi: 10.1016/s1059-1311(97)80058-1.
Two forms of unilateral tonic (hemitonic) seizure were observed in two adult epileptic patients with infantile hemiplegia. Their ictal EEGs showed diffuse bilaterally synchronous spike bursts without focal features. In one case, a 31-year-old male, the VTR/EEG recording clearly demonstrated hemitonic seizure which simultaneously involved his paretic limbs and body and were associated with loss of consciousness and autonomic signs. In the other case, a 33-year-old male, partial seizures with secondary unilateral generalization were demonstrated by VTR/EEG recording. The reason why these cases do not exhibit motor seizure activity on the unaffected side despite diffuse bilateral EEG changes, a lower motor threshold in the paretic limbs and inhibitory effect in the brain-stem on undamaged side are postulated. These two cases suggest that hemitonic seizures include heterogeneous characteristics of partial and generalized epilepsy. In patients with diffuse brain damage, such as those with infantile hemiplegia, seizures appear to exhibit complicated patterns, with characteristics of partial and generalized seizures. There is a gradiation of expression of unilateral seizure, range from clearly partial seizures to those with mostly features of generalized seizures, except for an asymmetry of motor expression.
在两名患有婴儿偏瘫的成年癫痫患者中观察到两种形式的单侧强直性（半身强直性）发作。他们的发作期脑电图显示双侧弥漫性同步棘波暴发，无局灶性特征。在一例中，一名31岁男性，视频脑电图记录清楚地显示半身强直性发作，同时累及他的瘫痪肢体和身体，并伴有意识丧失和自主神经症状。在另一例中，一名33岁男性，视频脑电图记录显示为部分性发作继发单侧泛化。尽管脑电图有双侧弥漫性改变，但这些病例在未受影响侧未表现出运动性发作活动，推测其原因是瘫痪肢体运动阈值较低以及脑干对未受损侧的抑制作用。这两例提示半身强直性发作包括部分性和全身性癫痫的异质性特征。在患有弥漫性脑损伤的患者中，如婴儿偏瘫患者，发作似乎表现出复杂的模式，具有部分性和全身性发作的特征。除了运动表现的不对称外，单侧发作的表现存在一个渐变过程，从明显的部分性发作到主要具有全身性发作特征的发作。
