【摘要】 目的 研究起源于对角沟的癫痫发作的常见临床表现，电生理特征，提高额叶癫痫的诊断能力及治疗水平。方法 回顾性分析2010年4月—2022年8月在广东三九脑科医院及深圳市第二人民医院进行手术评估的癫痫患者，经立体定向脑电图（Stereo-electroencephalography,SEEG）证实为对角沟起源的癫痫患者共5例，均有详细的病史记录，完整的头部核磁共振成像（Magnetic resonance,MRI）及正电子发射计算机断层成像（Positron emission computered tomography,PET-CT）检查，头皮脑电图均记录到多次典型临床发作，仔细阅读间歇期脑电图、发作期脑电图并仔细分析发作期症状学。结果 5例患者根据SEEG监测结果，可分为沟底型（3例）和非沟底型（2例），临床特点以强直发作合并复杂运动为特点，起源于左侧对角沟的患者强直症状相对突出，起始于右侧对角沟的患者强直症状可缺如。间歇期放电分布：沟底型间歇期放电相对较弥漫，可呈半球性或弥漫性癫痫样放电，非沟底型放电相对局限于前头部，但多侧裂上下同时受累及；发作期脑电图符合新皮层发作的特点，起始为电压性低减，沟底型发作起始较弥漫，非沟底型发作起始于前头部，侧裂上下同时受累及。结论 起始于对角沟的癫痫发作以强直发作合并复杂运动为特点，可以分为沟底型和非沟底型，沟底型与非沟底型具有不同的电生理特点。更多还原

【Abstract】 Objective To research clinical manifestations, electrophysiological characteristics of epileptic seizures arising from diagonal sulci(DS), to improve the level of the diagnosis and treatment of frontal epilepsy.Methods We reviewed all the patients underwent a detailed presurgical evaluation, including 5 patients with seizures to be proved originating from diagonal sulci by Stereo-electroencephalography(SEEG). All the 5 patients with detailed medical history, head Magnetic resonance(MRI), the Positron emission computered tomography(PET-CT) and psychological evaluation, habitual seizures were recorded by Video-electroencephalography(VEEG) and SEEG, we review the intermittent VEEG and ictal VEEG, analyzing the symptoms of seizures. Results 5 patients were divided into 2groups by SEEG, group 1 including 3 patients with seizures arising from the bottom of DS, group 2 including 2 patients with seizures arising from the surface of DS, all the tow groups with seizures characterized by both having tonic and complex motors, tonic seizures were prominent in seizures from left DS, and tonic seizures may absent in seizures from right DS. Intermittent discharges with group1 were diffused, and intermittent discharges with group 2 were focal, but both brain areas of frontal and temporal were infected. Ictal EEG findings were consistent with the characteristics of neocortical seizures, the onset EEG shows voltage attenuation, seizures from bottom of DS with diffused EEG onset, and seizures from surface of DS with more focal EEG onset, but both frontal and anterior temporal regions were involved. Conclusion the symptom of seizures arising from DS characterized by tonic and complex motor, can be divided into seizures arising from the bottom of DS and seizures from the surface of DS, with different electrophysiological characters.更多还原