Murthy J M, Yangala R
Department of Neurology, Nizam's Institute of Medical Sciences, Panjagutta, Hyderabad, India.
J Neurol Sci. 1998 Jun 11;158(1):65-70. doi: 10.1016/s0022-510x(98)00093-8.
Putative etiology was studied in 991 patients with symptomatic localization-related epilepsies seen in a university hospital in South India. They formed 39% of patients with various types of epilepsies and epileptic syndromes seen during the study period. Seizure occurred in close temporal association with an acute central nervous system (CNS) insult in 53% of patients. Infections of CNS including single CT enhancing lesion (SCTEL) accounted for 77% of patients with acute symptomatic epilepsy. Cerebrovascular diseases were the risk factors in 48% of patients with remote symptomatic epilepsy. Neurocysticercosis, SCTEL and small single cerebral calcific CT lesion (SSCCCTL) together accounted for 40% of etiological factors and neurotuberculosis for 10%. Infections of the central nervous system and SCTEL together were the putative risk factors in 52% of patients aged < or =40 years. Cerebrovascular diseases were the etiological factors in 64% of patients aged >40 years. Neurological handicaps from birth manifested by mental retardation and/or cerebral palsy was the feature in 21% of children. The type of seizure was either simple partial or complex partial with or without secondary generalization in 76% of patients. The remaining patients presented with either generalized tonic clonic seizures or unlocalized seizures. Localization to a single site of seizure origin proposed by the International League Against Epilepsy (ILAE) was possible in only 67.5% of patients. The most readily identifiable was motor cortex. In patients with unlocalized or generalized seizures the type of pathology was diffuse in 17% of patients and in 48.5% of patients, the lesion was located in the frontal brontoparietal lobe.
对印度南部一家大学医院收治的991例有症状的局灶性相关性癫痫患者的可能病因进行了研究。他们占研究期间所见各类癫痫和癫痫综合征患者的39%。53%的患者癫痫发作与急性中枢神经系统（CNS）损伤在时间上密切相关。中枢神经系统感染，包括单发CT强化病灶（SCTEL），占急性症状性癫痫患者的77%。脑血管疾病是48%的远隔症状性癫痫患者的危险因素。神经囊尾蚴病、SCTEL和单发小的脑钙化CT病灶（SSCCCTL）共同占病因的40%，神经结核占10%。中枢神经系统感染和SCTEL共同是52%年龄≤40岁患者的可能危险因素。脑血管疾病是64%年龄＞40岁患者的病因。21%的儿童有出生时即存在的以智力发育迟缓或脑瘫为表现的神经功能障碍。7介的患者癫痫发作类型为单纯部分性或复杂部分性发作，伴或不伴继发全面性发作。其余患者表现为全面性强直阵挛发作或未定位发作。国际抗癫痫联盟（ILAE）提出的癫痫发作起源于单一部位的定位仅在67.5%的患者中可行。最容易识别的是运动皮层。在未定位或全身性发作的患者中，17%的患者病理类型为弥漫性，48.5%的患者病灶位于额颞顶叶。
