颞叶内侧癫痫患者的影像学、症状学及脑电图分析  

Imaging,symptomology and EEG analysis of medial temporal lobe epilepsy

作　　者：郑远征[1] 李坷[1] 张继中[1] ZHENG Yuanzheng;LI Ke;ZHANG Jizhong(Department of Neurology,the First People's Hospital of Nanyang,Nanyang(473000),Henan China)

机构地区：[1]南阳市第一人民医院神经内科,河南南阳473000

出　　处：《癫痫与神经电生理学杂志》2020年第6期338-341,共4页Journal of Epileptology and Electroneurophysiology(China)

摘　　要：目的:探讨颞叶内侧癫痫(MTLE)的影像学、症状学及脑电图的多样性表现。方法:选择2018年5月至2020年4月南阳市第一人民医院神经内科收治的颞叶内侧癫痫患者75例作为研究对象,设为观察组;选择同期治疗的颞叶外侧癫痫患者68例作为对照组。两组患者入院后均作长程视频脑电图监测,记录患者症状学表现;比较两组患者的影像学、症状学和视频脑电图特点。结果:两组患者的症状学主要表现为先兆发作、自动症、对侧肢体强直发作和(或)肌张力障碍、继发全面强直阵挛发作,两组比较差异无统计学意义(P>0.05);观察组患者中部分患者伴有多脑叶放电(11%)、双侧放电(49%)、同步放电(12%)及睡眠期间放电(13%),而对照组脑电图多脑叶放电、同步化放电、睡眠期间放电不明显,但是双侧放电明显(23%);75例颞叶内侧癫痫患者均完成MRKPET检查,头部MRI结果表现为颞角扩大,海马信号增高;头部PET检查显示颞极及海马代谢减低。结论:颞叶内侧癫痫患者影像学异常明显,且常伴有典型的症状学,加强患者脑电图检查能进一步明确疾病,可指导临床治疗。Objective:To investigate the diverse manifestations of imaging,symptoms and EEG of medial temporal lobe epilepsy(MTLE),Methods:From May 2018 to April 2020.75 patients with MTLK were selected as the observation group,and 68 patients with lateral temporal lobe epilepsy treated in the same period were selected as the control group.After the two groups were admitted to the hospital,the patients were monitored by long-term video and their symptoms were recor ded;the imaging,symptoms,and video characteristics of the two groups were compared.Re­sults:The symptomatic expressions of both groups were mainly manifested as aura onset,automa tism.conlralateral limb rigidity dystonia,and secondary general tonic-clonic seizures.There was no statistically significant difference(P>0.05).Part of the observation group were accompanied by mul­tiple brain lobes discharge(10.67%),bilateral discharge(49.33%),synchronous discharge(12.00%)and discharge during sleep(13.33%).while the control group had multiple brain lobes dis charge and synchronized discharge on EEG.The discharge was not obvious during sleep,but the hi lateral discharge was obvious(23.53%);75 caseS with mTLE had completed MRI and PET examina tions.The head MRI showed that the temporal horn was enlarged and the hippocampus signals in creased;PET examination of the head showed metabolism of temporal pole and hippocampus de­creased.Conclusion:The imaging of patients with mTLE is obvious,and was often accompanied by typical symptoms.To strengthen EEG examination can further clarify the disease and guide clinical treatment.It is worthy of promotion and application.

关 键 词：颞叶内侧癫痫(MTLE) 影像学 症状 电生理 多样性表现 

分 类 号：R742.1[医药卫生—神经病学与精神病学] R741.044[医药卫生—临床医学]