额叶癫癎发作的临床特征及脑电图分析

目的：探讨额叶癫癎发作的临床特征、脑电图（EEG）特点及临床意义.方法：回顾性分析30例经手术证实发作起源于额叶的药物难治性额叶癫癎患者87次临床发作症状、发作期及发作间期的头皮EEG特点.结果：额叶癫癎发作形式复杂多样,常见的发作形式有姿势性强直发作、过度运动性自动症、扭转性强直、阵挛性发作、发声、失神等,有时出现发作性情绪改变或自主神经症状等少见症状.额叶癫癎常见以下发作特点：发作频繁,常成簇出现,发作起止突然,持续时间短暂,发作后意识恢复快,以睡眠中发作为主.额叶癫癎发作间期EEG阳性率较低,额区棘波、尖波出现率相对较低,且波形不典型,发作期额叶限局性或弥漫性的改变与背景活动的差别不明显.结论：额叶癫癎临床和EEG不典型是导致额叶癫癎发作临床诊断困难的主要原因,认识额叶癫癎发作的临床特点,延长EEG记录时间,认真分析发作症候学、发作期同步EEG有助于明确诊断.

The clinical and electroencephalographic characteristics of frontal lobe epilepsy

Objective To explore the clinical and eleetroeneephalographic characteristics of frontal lobe epilepsy（FLE）. Methods：The clinical symtoms of seizures interietal and ietal, EEG changes of 87 seizures in 30 patients with intractable FLE verified by successful resective surgeries were analysed retrospectively. Results： The clinical seizures of FLE were complex,including asymmetric tonic seizures, hypermotor automatisms, torsive seizures, elonie seizures, vocalization, absence, emotional changes and paroxysmal autonomic symptoms etc. Frontal lobe seizures were often exhibited in relatively short duration, whereas the frequent nocturnal attacks usually occurred without postietal mental confusion. Spikes or sharps during interietal EEG were infrequent in atypical patterns. Ietal EEG showed focal discharges in frontal areas or diffused changes with no obvious difference frorm background activity. The ictal epileptic discharges might be of assistance for their diagnosis in view of the lack of interietal EEG positive findings in some cases. Conclusion Praetically the FLE uncommonly occurred,with atypical clinical and EEG manifestions,which made diagnosis more difficult. The recognition of the features of frontal lobe seizures, prolonged duration of video EEG record, and synchronous analyses of ietal clinical and EEG manifestions might be helpful to the diagnosis of frontal lobe seizures.