Kanemoto K, Takuji N, Kawasaki J, Kawai I
Kansai Regional Epilepsy Center, Utano National Hospital, Kyoto, Japan.
J Neurol Neurosurg Psychiatry. 1998 Feb;64(2):245-8. doi: 10.1136/jnnp.64.2.245.
This study aimed to examine the close correlation between complicated febrile convulsions (CFC) and medial temporal lobe epilepsy and to delineate characteristics of temporal lobe epilepsy with CFC. Patients with temporal lobe epilepsy were divided into those with a prior episode of CFC (n=52), those with febrile convulsions other than CFC, and those without either (n=345). Clinical constellations, neuroimaging, drug resistance, and effects of temporal lobectomy of the three groups were compared. A close association between CFC and temporal lobe epilepsy was confirmed. The salient features of temporal lobe epilepsy with CFC were early age at onset of habitual seizures (about 10 years), the predominance of autonomic auras, and a high incidence of MRI evidence of unilateral medial temporal sclerosis. Patients with temporal lobe epilepsy with prior CFC had an excellent outcome after surgery, by contrast with an unfavourable response to drug therapy. The surgical results were discouraging in patients with temporal lobe epilepsy without history of any febrile convulsions and without solid brain tumours. These results indicate surgical intervention as the choice of therapy in a substantial number of patients with temporal lobe epilepsy with a history of CFC.
本研究旨在探讨复杂性热性惊厥（CFC）与内侧颞叶癫痫之间的密切关联，并描绘伴有CFC的颞叶癫痫的特征。将颞叶癫痫患者分为有CFC既往发作史的患者（n = 52）、有非CFC热性惊厥的患者以及两者均无的患者（n = 345）。比较了三组患者的临床症状、神经影像学表现、耐药性以及颞叶切除术的效果。证实了CFC与颞叶癫痫之间存在密切关联。伴有CFC的颞叶癫痫的显著特征为习惯性发作起病年龄早（约10岁）、自主神经发作先兆占优势以及单侧内侧颞叶硬化的MRI证据发生率高。与药物治疗反应不佳相比，有CFC既往史的颞叶癫痫患者术后预后良好。对于无任何热性惊厥病史且无实性脑肿瘤的颞叶癫痫患者，手术结果令人沮丧。这些结果表明，手术干预是大量有CFC病史的颞叶癫痫患者的治疗选择。
