Bertol V, Oliveros A, Gros B, Serrano C
Servicio de Neurología, Hospital Miguel Servet, Zaragoza, España.
Rev Neurol. 1997 Apr;25(140):518-22.
In complex partial crises (CPC) some characteristics of the way in which they occur may be helpful in localizing the focus of origin in the cerebral cortex. Thus, the appearance of any kind of status epilepticus will not predominate depending on the origin of the epileptic focus, but the complex partial state will be rare when the origin is temporal and more frequent when the origin is frontal. The appearance of CPC in a cluster form is, on the other hand, characteristic of crises originating in the frontal lobe.
We review the clinical history of 151 epileptics with CPC, evaluating the way in which the crises appear, together with other clinical data. We define the start of the crisis in a specific lobe, when this was the site of maximum voltage of the epileptic anomaly or of maximum phase opposition.
10% of the patients showed grouping of their CPC; in the remainder the appearance was isolated, 15% showed status epilepticus at some point in their illness. We found a statistical difference when relating this to the anomalous topography of the EEG; between 15% and 42% more patients with status epilepticus were counted when the topography of the anomaly in the EEG was extratemporal. There was also between 37.2% and 76.4% more patients with cluster crises in the cases with an extratemporal focus.
在复杂部分性发作(CPC)中,发作方式的一些特征可能有助于确定大脑皮层的起源部位。因此,任何类型癫痫持续状态的出现并不取决于癫痫病灶的起源,但当起源于颞叶时,复杂部分性状态很少见,而起源于额叶时则更常见。另一方面,CPC以簇状形式出现是额叶起源发作的特征。
我们回顾了151例CPC癫痫患者的临床病史,评估发作方式以及其他临床数据。当癫痫异常的最大电压部位或最大相位相反部位位于特定脑叶时,我们将发作起始部位定义在该脑叶。
10%的患者CPC呈成组发作;其余患者发作表现为孤立性,15%的患者在病程中的某个阶段出现癫痫持续状态。当将其与脑电图异常部位相关联时,我们发现了统计学差异;当脑电图异常部位在颞叶外时,癫痫持续状态患者的数量多出15%至42%。在颞叶外病灶的病例中,簇状发作的患者数量也多出37.2%至76.4%。