癫痫性眼震临床视频脑电图及核磁影像学特征  

Video EEG magnetic resonance imaging and clinical features in patients with epileptic nystagmus

作　　者：王丽英[1] 岳云龙[2] 孟然[3] 

机构地区：[1]首都医科大学附属北京世纪坛医院功能神经外科,北京100038 [2]首都医科大学附属北京世纪坛医院影像科,北京100038 [3]首都医科大学宣武医院神经内科,北京100053

出　　处：《中风与神经疾病杂志》2013年第12期1080-1083,共4页Journal of Apoplexy and Nervous Diseases

基　　金：国家自然基金面上项目(30770741);北京市215人才项目(2009-03-02)

摘　　要：目的分析癫痫性眼震的临床表现、视频脑电图和核磁影像学特征。方法回顾性分析我院5例癫痫性眼震患者的临床表现、视频脑电图及神经影像学特点。结果 5例患者(男4例,女1例)发作时表现为双眼水平同向性眼震和眼球偏斜,其中伴头偏斜3例,视物不清2例,视幻觉1例,眩晕1例。脑电图特征:致痫灶主要位于颞-顶-枕交界区,和眼震方向相反;位于左侧3例,右侧2例。起源于枕、后颞、顶区(枕区为著)的10-14HZ棘波节律。MRI影像特征:左顶枕叶软化灶1例,右侧颞叶软化灶1例,右侧额、顶、颞叶大片状软化灶1例,2例头部核磁未见异常。结论癫痫性眼震是一种少见的痫性发作,病灶主要位于枕或颞-顶-枕交界区,痫性放电多起源于枕、后颞和顶区,眼震的方向偏向病灶和/或癫痫样放电的对侧。Objective To analyze the features of the epileptic nystagmus on the aspects of clinical presentation, Vid- eo EEG and magnetic resonance imaging. Methods The features of clinical presentation, Video EEG and magnetic reso- nance imaging in a total of 5 EEG confirmed epileptic with nystagmus were analyzed retrospectively. Results A total of 5 patients showed a binocular syntropy horizontal nystagmus and conjugate eye deviation, moreover,3 out of the 5 cases ac- companied with head deviatlon,another 2 cases with blurred vision, 1 case with visual hallucination and 1 case with vertigo. The ictal EEG revealed that the 10-14HZ spike waves, mainly originated from the temporal-parietal-occipital border area, op- posed to the direction of the nystagmus （3 left and 2 right in this case series study）. Brain melting lesions located at left pa- rietal-occipital area （1 case）, right temporal lobe （1 case） and right frontal-parietal-occipital area （1 case）, but two cases were without any brain lesion in the 3.0T magnetic resonance imaging. Conclusions Epileptic nystagmus is a rare type of epilepsy with temporal-parietal-occipital border area lesion and/or the ictal epileptic discharges, the direction of the nystag- mus usually contralateral to the brain lesion and/or the ictal discharges.

关 键 词：癫痫性眼震 视频脑电图 神经影像学 

分 类 号：R742.1[医药卫生—神经病学与精神病学]