Mikuni N, Ikeda A, Terada K, Taki W, Kikuchi H, Kimura J, Sengoku A, Shibasaki H
Department of Brain Pathophysiology, Kyoto University School of Medicine, Japan.
J Clin Neurophysiol. 1997 Nov;14(6):507-12. doi: 10.1097/00004691-199711000-00007.
We report 3 patients with medically intractable complex partial seizures (CPS) arising from the temporal lobe judged by surgical outcome, in whom scalp electroencephalogram (EEG) showed ictal epileptiform discharges at the frontopolar region. In all patients, results of cranial magnetic resonance imaging (MRI), positron emission tomography (PET), and ictal single photon emission computed tomography (SPECT) were consistent with those of temporal lobe epilepsy (TLE). The epileptogenic area was defined in the temporal lobe by chronic subdural recording in 2 patients. After surgical treatment (amygdalohippocampectomy, anterior temporal lobectomy, and temporal lesionectomy, respectively), all 3 patients became seizure-free and the interictal frontopolar epileptiform discharges on scalp EEG disappeared. Patients with TLE may show ictal scalp EEG with frontopolar onset. This is most likely explained by direction of dipolar orientation of epileptiform discharges in 1 of our patients; rapid spread of ictal activity to the frontopolar area can also be considered in the 2.
我们报告了3例经手术结果判定为起源于颞叶的药物难治性复杂部分性发作（CPS）患者，其头皮脑电图（EEG）显示额极区发作期癫痫样放电。所有患者的头颅磁共振成像（MRI）、正电子发射断层扫描（PET）和发作期单光子发射计算机断层扫描（SPECT）结果均与颞叶癫痫（TLE）相符。2例患者通过慢性硬膜下记录在颞叶确定了癫痫病灶区。经过手术治疗（分别为杏仁核海马切除术、前颞叶切除术和颞叶病灶切除术）后，所有3例患者均无癫痫发作，头皮EEG上的发作间期额极癫痫样放电消失。TLE患者的发作期头皮EEG可能出现额极起始。这很可能可以用我们其中1例患者癫痫样放电的偶极方向来解释；另外2例也可考虑发作期活动快速扩散至额极区。
