【摘要】 目的:探讨颞叶癫痫的病因、临床特征、发作期及发作间期脑电图特点和治疗效果。方法:对23例诊断为颞叶癫痫的住院病人的临床特征、脑电图和神经影像学资料及治疗效果进行回顾性分析。结果:23例患者中有18例有强直阵挛性发作(GTCS),21例有复杂部分性发作(CPS),其中5例合并有单纯部分性发作(SPS)。患者常规脑电图和24h脑电监测(Video-EEG,VEEG),共记录到18次临床发作,均为CPS。VEEG除一例正常外,8例主要表现为起源于单侧或双侧颞叶或额叶的棘波。常规脑电图3例未见明显异常,其余均有单侧或双侧颞叶的棘波、棘慢波综合、尖波、尖慢波发放,19例蝶骨电极14例为阳性。2例患者服丙戊酸钠,其余患者停服原抗癫痫药,改为卡马西平(得理多),发作控制出院。结论:颞叶癫痫是一组部分性症状性癫痫综合征,多表现为复杂部分性发作,病因多为血管畸形、良性肿瘤、海马硬化。EEG常见单侧或双侧颞叶的棘波。卡马西平(得理多)是治疗颞叶癫痫的首选药物,正确的诊断可以提高对病因和对症治疗的效果。更多还原

【Abstract】 Objective: To explore the etiology, clinical feature, the characteristics of interictal and ictal electroencephalography(EEG) and the clinical therapeutic efficacy of patients with temporal lobe epilepsy (TLE). Methods: Twenty-three patients with TLE were assessed for clinical observation, EEG, imaging scanning and therapeutic efficacy. Results: Of the 23patients with TLE, generalized tonic-clonic seizure (GTCS) were found in 18 patients, complex partial seizure (CPS) in 21 patients, of 5 patients were also with simple partial seizure (SPS). By EEG and video-EEG (VEEG), 18 seizure were recorded, all being CPS. EEG of 3 patients were not abnormal, EEG of the others recorded epileptiform discharges originated from one side or both sides of temporal lobe. VEEG recorded spike wave and spike wave complex originated from one or both sides of temporal lobe. Twenty-one patients treated with Carbamazepine or Tegretal and 2 patients treated with sodium valproate were seizure-free. Conclusions : TLE is a group of partial and symptomatic epilepsy syndrome. CPS were ofren found in patients with TLE. The etiology of TLE are cerebrovascular malformation, tumor and hippocampus sclerosis. EEG records spike waves in one or both sides of temporal lobe. CBZ or Tegretal is the first choice to the therapy of TLE. The correct diagnosis is the key point to therapy.更多还原