额叶癫痫的录像脑电图分析

目的:探讨额叶癫痫的临床特征、发作期和发作间期的脑电图特点。方法:使用录像脑电图(VEEG)对42例额叶癫痫患者进行长程脑电监测,分析和总结额叶癫痫的临床表现及脑电图所见。结果:42例患者中有可循病因者16例,未发现病因者26例;临床表现复杂,运动症状突出,常迅速泛化,主要形式有局灶阵挛性发作、不对称性强直性发作、假自主运动发作、也可见失神样发作及痴笑发作等其它少见形式。发作间期脑电图能定位于额叶者27例,占64.3%;26例监测到临床发作,发作前2-14 s额区出现爆发性异常节律,发作期由于大量动作伪迹和肌电伪差干扰,影响起源判断。结论:额叶癫痫是一组临床表现复杂多样的癫痫综合征,发作前瞬间的脑电图改变具有重要的定位诊断意义。

Video-Electroencephalogram of Frontal Lobe Epilepsy

Objective: To explore clinical features,ictal and interictal EEG characteristics of frontal lobe epilepsy(FLE).Methods: Forty-two patients were studied with the long term video-EEG(VEEG) monitoring.Clinical data and EEG findings were analyzed.Results: In 42 patiens,16 cases had etiological factors such as cerebral trauma,cerebromalacia and so on,but 26 cases had no evidence of brain lesions.The clinical manifestations of FLE were complex with outstanding motor symptoms and often rapidly generalized.The main seizure patterns included focal clonic seizures,asymmetric tonic seizures,pseudovoluntary movement,rarely absence seizures,gelastic seizures and so on.The epileptiform discharges in interictal EEG could be localized in frontal region in 27 patients(64.3%).In 26 cases,clinical seizures were captured by video.The burstly abnormal rhythm in frontal region appeared in 2-14 s before clinical attacks.Because of existence of a lot of motor artifacts and diffuse EMG artifacts in ictal,it was difficult to judge the origin of epileptic discharges.Conclusion: FLE is a syndrome with extremely complex and diverse epileptic clinical manifestations.The transient changes in EEG before clinical onset were of more important localizing value for FLE.