Dupont S, Semah F, Baulac M, Samson Y
Unité d'Epileptologie, Clinique Neurologique Paul Castaigne Hôpital de la Pitié-Salpêtrière, Paris, France.
Neurology. 1998 Nov;51(5):1289-92. doi: 10.1212/wnl.51.5.1289.
Unilateral dystonic posturing of limbs occurs frequently in medial temporal lobe epilepsy (MTLE) but its underlying anatomic basis is still unknown.
To investigate the pathophysiology of dystonic posturing, we examined the relation between the occurrence of dystonia and interictal cerebral metabolic abnormalities using fluorodeoxyglucose (FDG)-PET in MTLE patients.
Video recordings of 30 patients with documented MTLE were reviewed to assess the presence of ictal dystonic posturing. Interictal FDG-PET was performed in all patients.
Eighteen patients exhibited dystonic posturing--contralateral to the seizure focus in 16 cases, bilateral in one, and ipsilateral in one. Dystonia was statistically associated with more severe hypometabolism in the striatal and in the orbitofrontal regions ipsilateral to the seizure focus.
Hypometabolism observed in the striatal region of patients with ictal dystonic posturing suggests that the basal ganglia are involved in the generation of ictal dystonic posturing in MTLE.
肢体单侧张力障碍性姿势在颞叶内侧癫痫（MTLE）中频繁出现，但其潜在的解剖学基础仍不清楚。
为了研究张力障碍性姿势的病理生理学，我们使用氟脱氧葡萄糖（FDG）-PET检查了MTLE患者中肌张力障碍的发生与发作间期脑代谢异常之间的关系。
回顾了30例有记录的MTLE患者的视频记录，以评估发作期张力障碍性姿势的存在情况。所有患者均进行了发作间期FDG-PET检查。
18例患者出现张力障碍性姿势——16例与癫痫病灶对侧，1例双侧，1例同侧。肌张力障碍与癫痫病灶同侧的纹状体和眶额区域更严重的代谢减低在统计学上相关。
发作期有张力障碍性姿势的患者纹状体区域出现的代谢减低表明基底神经节参与了MTLE发作期张力障碍性姿势的产生。
