顶叶内侧—解剖、生理与癫痫_Journal of Epilepsy

Authors：

王薇薇 ,  吴逊

北京大学第一医院神经内科（北京 100034）;

Corresponding author：

吴逊, Email: bxtong@163.com

Keywords：

癫痫; 顶叶内侧; 楔前叶; 后扣带回

DOI：

10.7507/2096-0247.202208003

Video：

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顶叶内侧主要包括楔前叶、后扣带皮质及压后皮质，为默认网络的关键部位，其功能尚未完全了解，与空间认知，记忆及图形方向的认知有关，并参与意识过程。顶叶内侧癫痫极为少见，又因起源于顶叶内侧面，因此对其特征，诊断标准的研究不多。主要分为两大类型：① 楔前叶癫痫，楔前叶与其他皮质区及皮质下结构有广泛的联系，可分为三部分：前感觉运动亚区、中认知亚区、后感觉亚区。发作症状包括前庭症状、视觉症状，还有运动症状；② 后扣带回癫痫，发作时有四种症状：过度运动、不对称性强直性姿势、自动症及呆滞发作。上述症状多数为发作发放扩布至其他脑区后出现的。头皮脑电图无定位价值，仅有颅内电极尤其是立体定向脑电图才能确定致痫区。绝大部分为药物难以控制发作者，一旦确诊外科治疗为最佳选择。

Citation： 王薇薇, 吴逊. 顶叶内侧—解剖、生理与癫痫. Journal of Epilepsy, 2022, 8(6): 550-554. doi: 10.7507/2096-0247.202208003 Copy

1.	Vogt BA, Vogt L, Laureys S. Cytology and funtionally correlated circuit of human posterior cingulated area. Neuro Image, 2006, 29: 452-466.
2.	Leech R, Sharp DJ. The role of the posterior cingulate cortex in cognitive and disease. Brain, 2014, 137: 12-32.
3.	Khan SA, Carney PW, Archer JS. Brief asymmetric tonic posturing with diffuse low-voltage fast activity in seizures arising from the mesial parietal region. Epilepsy Research. 2014, 108(10): 1950-1954.
4.	Duncan JS. Occipital and parietal lobe epilepsies. In:Sander JW, Gunn FJ, Smolls JE (editors). Epilepsy. Chesham Lane, UK, 2009: 155-158.
5.	Kursun O, Karatas H, Dericioglu N, et al. Refractory lesional parietal lobe epilepsy: clinical, electroencephalographic and neurodiagnostic findings. Arch Neuropsychiatry, 2016, 53: 213-221.
6.	Mailo J, Tang-Wai R. Insight into the precuneus: a novel seizure semiology in a child with epilepsy arising from the right posterior precuneus. Epileptic Disord, 2015, 17(3): 321-327.
7.	Cavana AE. The precuneus and consciousness. CNS Spectr, 2007, 12(7): 545-552.
8.	Cavana AE, Trimble MR. The precuneus: a review of its functional anatomy and behaviounal correlates. Brain, 2006, 129: 564-583.
9.	Harroud A, Baucher O, Tran TPY, et al. Precuneual epilepsy: Clinical feature and surgical outcome. Epilepsy & Behavior, 2017, 73: 77-82.
10.	Umeoka S, Baba K, Terada K, et al. Bilateral symmetric tonic posturing suggesting propapation to the supplementary motor area in a patient with precuneate cortical dysplasia. Epileptic Disord, 2007, 9(4): 443-448.
11.	Abcu-Khalil B. Semiology of mesial frontal and parietal lobe epilepsy. In: Kaubeissi Maciunas RJ: Progress in epileptic disorders. Extratemporal lobe epilepsy surgery. John Lobbey. France, 2011: 43-63.
12.	Gibbs SA, Figarilli M, Cassacedi G, et al. Sleep related hypermotor seizures with a right parietal onset. J Clin Sleep Medicine. 2015, 11(8): 953-955.
13.	Ogiso T, Kobayashi K, Sugishita M. The precuneus in motor imagery: a magnetoencepholographic study. Neuro Report. 2000, 11(6): 1345-1349.
14.	Balestrini S, Francione S, Mai R, et al. Multimodal response induced by cortical stimulation of the parietal lobe: a stereo-electroencephalograuphy study. Brain, 2015, 138(9): 2596-2607.
15.	Eliashiv DS, Elsas SM, Squires K, et al. Ictal magnetic source imaging as a localiging tool in partial epilepsy. Neurology, 2002, 59: 1600-1610.
16.	Wiest G, Zimprich F, Prayer D, et al. Vistibular processing in human paramedian precuneus as shown by electrical cortical stmulation. Neurology, 2004, 62: 473-475.
17.	Yang Y, Wang H, Zhou W, et al. Electroclinical characteristics of seizures arising from the precuneus based on stereo-electroencephalography (SEEG). BMC Neurology, 2018, 18: 110-120.
18.	Ikeda A, Sato T, Ohara S, et al. “Supplementary motor area (SMA) seizure” rether than “SMA epilepsy” in optimal surgical candidates: a document of subdural mapping. J Neurological Science, 2002, 202: 43-52.
19.	Bartolomei F, Gavaret M, Hewett R, et al. Neural networks underlying parietal lobe seizures: a quantified study from intracerebral recording. Epilepsy Research, 2011, 93(2-3): 164-174.
20.	Francione S, Liava A, Mai R, et al. Drug-resistant parietal epilepsy: poly morphic ictal semiology does not preclude good post-surgical outcome. Epileptic Disord, 2015, 17(1): 32-46.
21.	Liava A, Mai R, Tassi L, et al. Paediatric epilepsy surgery in the posterior cortex: a study of 62 cases. Epileptic Disord, 2014, 16(2): 141-173.
22.	Frings L, Wangner K, Quiske A, et al. precuneus is involved in allocentric spatial location encoding and recognition. Exp Brain Res, 2006, 173: 661-672.
23.	Enatsu R, Bulacio J, Nair DR, et al. Posterior cingulate epilepsy: clinical and neurophysislogical analysis. J Neurol Neusurg Psychiatry, 2014, 85(1): 44-50.
24.	Leech R, Smollword J. The posterior cingulate cortex: Insight from structure and function. In:vogt BA(editor):Handbook of Clinical Nourology(3^rd series), 2019: 73-85.
25.	Alkawadri R, So NN, Von Ness PC, et al. Cingulate epilepsy. Report of 3 electroclinical subtype with surgical outcome. JAMA Neurol, 2013, 70: 995-1002.
26.	Koubeissi MZ, Jauny CC, Balkeley JO, et al. Analysis of dynamics and propagation of parietal cingulate seizures with secondary mesial femporal involvement. Epilepsy & Behavior, 2009, 14(1): 108-112.
27.	Garzen E, Lüders HO. Cingulate epilepsy. In:Lüders HO. (editor):Textbook of epilepsy surgery. London, Informa Healthcare, UK, 2008: 334-353.
28.	Montovont A, Kahan P, Catenoix H, et al. Hypemotor seizures in lateral and mesial parietal epilepsy. Epilepsy & Behavior, 2013, 28(3): 408-412.
29.	Chou CC, Lee CC, Lin CF, et al. Cingulate gyrus epilepsy: semiology, invasive EEG, and surgical approaches. Neurosurgical focus, 2020, 48(4): 1-6.
30.	Wang AW, Moien-Afshari F. Focal DBS of posterior cingulate cortex for refractory nonlesional epilepsy: a case report, Le J Canadien des Sciences Neurologiques, 2019, 18(Suppl 2): S27-S28.
31.	Goren OM, Moffat BA, Damond PM, et al. Seven-testa quantitative magnetic resonance spectroscope of qlutamate, γ-aminobutyric acid, and glutathione in the posterior cingulate cortex / precuneus in patient with epilepsy. Epilepsia, 2020, 61(12): 2785-2794.
32.	von lehe M, Wagner J, Clusmann H, et al. Epilepsy surgery of the cingulate gyrus and the frontal mesial cortex. Neurosurgery. 2012, 70: 900-910.

1. Vogt BA, Vogt L, Laureys S. Cytology and funtionally correlated circuit of human posterior cingulated area. Neuro Image, 2006, 29: 452-466.
2. Leech R, Sharp DJ. The role of the posterior cingulate cortex in cognitive and disease. Brain, 2014, 137: 12-32.
3. Khan SA, Carney PW, Archer JS. Brief asymmetric tonic posturing with diffuse low-voltage fast activity in seizures arising from the mesial parietal region. Epilepsy Research. 2014, 108(10): 1950-1954.
4. Duncan JS. Occipital and parietal lobe epilepsies. In:Sander JW, Gunn FJ, Smolls JE (editors). Epilepsy. Chesham Lane, UK, 2009: 155-158.
5. Kursun O, Karatas H, Dericioglu N, et al. Refractory lesional parietal lobe epilepsy: clinical, electroencephalographic and neurodiagnostic findings. Arch Neuropsychiatry, 2016, 53: 213-221.
6. Mailo J, Tang-Wai R. Insight into the precuneus: a novel seizure semiology in a child with epilepsy arising from the right posterior precuneus. Epileptic Disord, 2015, 17(3): 321-327.
7. Cavana AE. The precuneus and consciousness. CNS Spectr, 2007, 12(7): 545-552.
8. Cavana AE, Trimble MR. The precuneus: a review of its functional anatomy and behaviounal correlates. Brain, 2006, 129: 564-583.
9. Harroud A, Baucher O, Tran TPY, et al. Precuneual epilepsy: Clinical feature and surgical outcome. Epilepsy & Behavior, 2017, 73: 77-82.
10. Umeoka S, Baba K, Terada K, et al. Bilateral symmetric tonic posturing suggesting propapation to the supplementary motor area in a patient with precuneate cortical dysplasia. Epileptic Disord, 2007, 9(4): 443-448.
11. Abcu-Khalil B. Semiology of mesial frontal and parietal lobe epilepsy. In: Kaubeissi Maciunas RJ: Progress in epileptic disorders. Extratemporal lobe epilepsy surgery. John Lobbey. France, 2011: 43-63.
12. Gibbs SA, Figarilli M, Cassacedi G, et al. Sleep related hypermotor seizures with a right parietal onset. J Clin Sleep Medicine. 2015, 11(8): 953-955.
13. Ogiso T, Kobayashi K, Sugishita M. The precuneus in motor imagery: a magnetoencepholographic study. Neuro Report. 2000, 11(6): 1345-1349.
14. Balestrini S, Francione S, Mai R, et al. Multimodal response induced by cortical stimulation of the parietal lobe: a stereo-electroencephalograuphy study. Brain, 2015, 138(9): 2596-2607.
15. Eliashiv DS, Elsas SM, Squires K, et al. Ictal magnetic source imaging as a localiging tool in partial epilepsy. Neurology, 2002, 59: 1600-1610.
16. Wiest G, Zimprich F, Prayer D, et al. Vistibular processing in human paramedian precuneus as shown by electrical cortical stmulation. Neurology, 2004, 62: 473-475.
17. Yang Y, Wang H, Zhou W, et al. Electroclinical characteristics of seizures arising from the precuneus based on stereo-electroencephalography (SEEG). BMC Neurology, 2018, 18: 110-120.
18. Ikeda A, Sato T, Ohara S, et al. “Supplementary motor area (SMA) seizure” rether than “SMA epilepsy” in optimal surgical candidates: a document of subdural mapping. J Neurological Science, 2002, 202: 43-52.
19. Bartolomei F, Gavaret M, Hewett R, et al. Neural networks underlying parietal lobe seizures: a quantified study from intracerebral recording. Epilepsy Research, 2011, 93(2-3): 164-174.
20. Francione S, Liava A, Mai R, et al. Drug-resistant parietal epilepsy: poly morphic ictal semiology does not preclude good post-surgical outcome. Epileptic Disord, 2015, 17(1): 32-46.
21. Liava A, Mai R, Tassi L, et al. Paediatric epilepsy surgery in the posterior cortex: a study of 62 cases. Epileptic Disord, 2014, 16(2): 141-173.
22. Frings L, Wangner K, Quiske A, et al. precuneus is involved in allocentric spatial location encoding and recognition. Exp Brain Res, 2006, 173: 661-672.
23. Enatsu R, Bulacio J, Nair DR, et al. Posterior cingulate epilepsy: clinical and neurophysislogical analysis. J Neurol Neusurg Psychiatry, 2014, 85(1): 44-50.
24. Leech R, Smollword J. The posterior cingulate cortex: Insight from structure and function. In:vogt BA(editor):Handbook of Clinical Nourology(3^rd series), 2019: 73-85.
25. Alkawadri R, So NN, Von Ness PC, et al. Cingulate epilepsy. Report of 3 electroclinical subtype with surgical outcome. JAMA Neurol, 2013, 70: 995-1002.
26. Koubeissi MZ, Jauny CC, Balkeley JO, et al. Analysis of dynamics and propagation of parietal cingulate seizures with secondary mesial femporal involvement. Epilepsy & Behavior, 2009, 14(1): 108-112.
27. Garzen E, Lüders HO. Cingulate epilepsy. In:Lüders HO. (editor):Textbook of epilepsy surgery. London, Informa Healthcare, UK, 2008: 334-353.
28. Montovont A, Kahan P, Catenoix H, et al. Hypemotor seizures in lateral and mesial parietal epilepsy. Epilepsy & Behavior, 2013, 28(3): 408-412.
29. Chou CC, Lee CC, Lin CF, et al. Cingulate gyrus epilepsy: semiology, invasive EEG, and surgical approaches. Neurosurgical focus, 2020, 48(4): 1-6.
30. Wang AW, Moien-Afshari F. Focal DBS of posterior cingulate cortex for refractory nonlesional epilepsy: a case report, Le J Canadien des Sciences Neurologiques, 2019, 18(Suppl 2): S27-S28.
31. Goren OM, Moffat BA, Damond PM, et al. Seven-testa quantitative magnetic resonance spectroscope of qlutamate, γ-aminobutyric acid, and glutathione in the posterior cingulate cortex / precuneus in patient with epilepsy. Epilepsia, 2020, 61(12): 2785-2794.
32. von lehe M, Wagner J, Clusmann H, et al. Epilepsy surgery of the cingulate gyrus and the frontal mesial cortex. Neurosurgery. 2012, 70: 900-910.

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