Kuzuya A, Yazawa S, Ikeda A, Nagamine T, Kunieda T, Taki W, Kimura J, Shibasaki H
Department of Neurology, Kyoto University School of Medicine.
Rinsho Shinkeigaku. 1997 Oct;37(10):923-6.
A 23-year-old, right handed women has suffered from supplementary motor seizures manifesting tonic followed by clonic contractions of the left foot, occasionally spreading to the left hand and trunk, since the age of 7 years. The mean frequency of seizures on admission was about 10 times per day. A brain MRI showed an abnormal intensity area about 3 cm in diameter in the right mesial frontal lobe involving the superior frontal and cingulate gyri. Six habitual seizures were recorded during long-term monitoring with digital EEG segments time-locked to the clonic contractions of the left foot, a negative spike was detected about 50 ms before the EMG onset at the midline fronto-central area slightly lateralized to the left. In the focal motor seizure arising from the mesial frontal lobe like in the present case, jerk-locked back averaging helps detecting the epileptiform activity which is otherwise undetectable.
一名23岁的右利手女性自7岁起就患有辅助运动性癫痫发作，表现为左脚强直性发作，随后是阵挛性收缩，偶尔会扩散到左手和躯干。入院时癫痫发作的平均频率约为每天10次。脑部MRI显示右内侧额叶有一个直径约3 cm的异常强化区域，累及额上回和扣带回。在长期监测期间，记录到6次习惯性发作，数字脑电图片段与左脚的阵挛性收缩进行时间锁定，在肌电图发作前约50 ms，在中线额中央区检测到一个负尖波，稍向左外侧化。在像本例这样起源于内侧额叶的局灶性运动性癫痫发作中， jerk-locked back平均法有助于检测到否则无法检测到的癫痫样活动。
