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目的探讨合并局灶性皮质发育不良、具有双重病理的颞叶癫痫患者的临床特征。方法回顾性分析40例具有颞叶内侧癫痫特征的病例,经组织病理学证实后将病例分为两组:海马硬化合并颞叶皮层局灶性皮质发育不良的病人24例为双重病理DP组,单纯海马硬化的病人16例为HS组。详细记录病人的一般临床资料、神经影像学检查、电生理检查、癫痫发作症状学及预后,两组之间进行比较。结果是否有全面性强直阵挛发作在两组之间有差异(P<0.01)。DP组的手术年龄和癫痫病程均较HS组少一些,发作开始的年龄大一些,但两组均无统计学差异。两组在是否合并高热惊厥、既往病史及预后等方面均无明显差异。结论合并局灶性皮质发育不良的颞叶双重病理与单纯性海马硬化病人很难从临床特征上区别,是否继发全面性强直阵挛发作可能起到一定的鉴别作用。
Objective To investigate the clinical features of patients with focal temporal cortex epilepsy complicated with focal cortical dysplasia and double pathology. Methods A retrospective analysis of 40 cases with temporal lobe medial epilepsy characteristics of the case confirmed by histopathology after the case was divided into two groups: hippocampal sclerosis with temporal cortex focal cortical dysplasia in 24 patients with double pathological DP group, 16 cases of simple hippocampal sclerosis in patients with HS group. Detailed records of the patient’s general clinical data, neuroimaging, electrophysiological examination, seizure symptoms and prognosis, were compared between the two groups. Results There was a difference in the prevalence of tonic-clonic seizures between the two groups (P <0.01). The duration of surgery and the duration of epilepsy in DP group were less than those in HS group, but the onset age was larger, but there was no significant difference between the two groups. The two groups in the merger of febrile seizures, past medical history and prognosis, no significant difference. Conclusions It is difficult to distinguish between the double pathology of temporal lobe with focal cortical dysplasia and simple hippocampal sclerosis from clinical features, and whether the secondary tonic clinoid seizures may play a role in differential diagnosis.