Chee M W, So N K, Dinner D S
Department of Neurology, Singapore General Hospital, Singapore.
J Clin Neurophysiol. 1997 May;14(3):226-9. doi: 10.1097/00004691-199705000-00007.
Two patients with seizures characterized by speech arrest had astrocytoma in the superior frontal gyrus (SFG) of the left hemisphere. Preoperative video EEG monitoring of seizures using subdural electrode arrays showed that comprehension, crude vocalization, and limb and tongue movements were preserved during speech arrest. One patient had difficulty writing during seizures. Ictal EEG onset was localized to the SFG without involvement of Broca's area. Electrical stimulation of SFG electrodes reproduced the speech arrest and writing difficulty. Resection of this region reduced seizures but did not result in lasting speech deficit. Cessation of speech with electrical stimulation of the superior frontal gyrus occurs by interrupting control of muscles required for speaking, which occurs independently of simple 'negative' motor effects. We postulate that functional redundancy is the basis for resection of this region without producing significant speech deficits.
两名以言语停顿为特征的癫痫患者，左半球额上回（SFG）存在星形细胞瘤。术前使用硬膜下电极阵列对癫痫发作进行视频脑电图监测显示，在言语停顿期间，理解能力、粗发声以及肢体和舌头运动均得以保留。一名患者在癫痫发作期间书写困难。发作期脑电图起始定位于额上回，未累及布洛卡区。对额上回电极进行电刺激可重现言语停顿和书写困难。切除该区域可减少癫痫发作，但未导致持久性言语缺陷。对额上回进行电刺激导致言语停止，是通过中断说话所需肌肉的控制实现的，这一过程独立于简单的“负性”运动效应。我们推测，功能冗余是切除该区域而不产生明显言语缺陷的基础。
