顶叶外侧癫痫—解剖、生理与临床_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：

顶叶癫痫; 顶上小叶; 顶下小叶; 中央后回; 外科治疗

DOI：

10.7507/2096-0247.202212010

Video：

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顶叶为联合皮质与其他脑叶有广泛的联系。顶叶癫痫少见仅为全部癫痫的1.4%。因其无特殊性症状且迅速扩布至其他脑叶，所以发作症状复杂，临床诊断困难。具有躯体感觉、体象障碍、前庭感觉这三种先兆，发作源于顶叶的可能性非常大。发作性症状多类似额叶或颞叶发作。头皮脑电图定位意义不大，因此多需要颅内电极监测以及影像学［如磁共振成像（Magnetic resonance imaging， MRI），发作时单光子发射计算机断层成像术（Single-photon emission computed tomography，SPECT）］检测。顶叶癫痫几乎均为药物难治性发作，定位明确的外科治疗60%～80%预后良好。

Citation： 王薇薇, 吴逊. 顶叶外侧癫痫—解剖、生理与临床. Journal of Epilepsy, 2023, 9(2): 134-141. doi: 10.7507/2096-0247.202212010 Copy

1.	Gleisomer U, Kuczaty C, Clusmann H, et al. Neuropsychological results in pediatric patients with epilepsy surgery in the parietal cortex. Epilepsia, 2008, 49(4): 700-704.
2.	Balestrinic S, Frandione S, Mai R, et al. Multimodal response induced by cortical stimulation of the parietal lobe: a stereo-electroencephalography study. Brain, 2015, 138(9): 2596-2607.
3.	Ristic AJ, Alexopoulos AV, So N, et al. Parietal lobe epilepsy: The great imitator among focal epilepsies. Epileptic Disord, 2012, 14(1): 22-31.
4.	Kursun O, Karatas H, Dericioglu N, et al. Refractory lesional parietal lobe epilepsy: clinical, electroencephalographic and neurodiagnostic fimdings. Arch Neuropsychiatry, 2016, 53(3): 213-221.
5.	Duncan JS. Occipital and parietal lobe epilepsies. In Sander JW, Rugg-Gunn FJ, Smalls JE(editors). Epilepsy 2009, Chesham Lane, UK, 2009: 155-158.
6.	Asodollahi M, Sperling MR, Rabiei AH, et al. Drug-resistant parietal lobe epilepsy: clinical manifestations and surgery outcome. Epileptic Disond, 2017, 19(1): 35-39.
7.	Salanova V. Parietal lobe epilepsy. J Clin Neurophysiol, 2012, 29(5): 392-396.
8.	Salanova V, Andermann F, Rasmussen T, et al. Tumoural parietal lobe epilepsy: clinical manifestation and outcome in 34 patients treated between 1934 and 1988. Brain, 1995, 118: 1289-1304.
9.	Binder DK, Podlogar M, Clusmann H, et al. Surgical treatment of parietal lobe epilepsy. J Neurosurg, 2009, 110(6): 1170-1778.
10.	Kim DW, Lee SK, Yun C-H, et al. Parietal lobe epilepsy: the semiology yield of diagnostic workup and surgical outcome. Epilepsia, 2004, 45(6): 641-649.
11.	Francione S, Liava A, Mai R, et al. Drug-resistant parietal epilepsy: polymorphic ictal semiology does not preclude good post-surgical outcome. Epileptic Disord, 2015, 17(1): 32-46.
12.	Salanova V. Parietal-occiptal lobe epilepsy. In Lüders HO（editor）: Textbook of epilepsy surgery. Informa USA. 2008: 314-319.
13.	Engel J, Pedly TA. Epilepsy: a comprehensive textbook, Second edition. Lippin-CoH Williams & walkins, 2009: 2471-2472.
14.	Shorvon S, Perucca E, Fish D, et al. The Treatment of Epilepsy. Second edition. Blackwell. USA, 2004: 11.
15.	Stephanic C, Lüders HO. Electrical stimulation of invasive electrodes in extratemporal lobe epilepsy. In: Kaubeissi MZ, Haciunas RJ. （editors） Progness in epileptic disorders. extratemporal lobe epilepsy surgery. John Labby, France, 2011: 65-75.
16.	Ebner A, Baier H. Electrical stimulation of the somatosensory cortex. In: Lüders HO, Noachtor S（editors）. Epileptic seizures pathophysiology and clinical semiology. Churchill Livinstone, New York, 2000: 187-191.
17.	Tuxhorn I, Kerdar MS. Somatosensory Aures. In: Lüder HO, Noachtar s (editors). Epileptic seizures pathophysiology and clinical semiology. Churchill Livinstone, New York, 2000: 182-191.
18.	Bartolomi F, Gavart M, Hewett R, et al. Neurol networks underlying parietal lobe seizures: a quential study from intracerebral recordings. Epilepsy Research, 2011, 93(2-3): 164-176.
19.	Velasco TR, Sakamoto AC. In: Koubeissi MZ, Maciunas RJ（editors）. Progress in epileptic disorders. Extratemporal lobe eilepsy surgery. Jahn Lebby, France, 2011: 65-75.
20.	Salonva V. Parietal lobe epilepsy, In: Vallar G Cosleh HB(editors). Handbook of Clinical Neurology Vol 151 (3rd series), 2018: 413-425.
21.	Kamali A, Sair HI, Radmonech A, et al. Decoding the superior parietal lobule connections of the superior longitudinal fasculus/arcuate fasciculus in the human brain. Neuroscience, 2014, 277(26): 577-583.
22.	Richer F, Martinez M, Robert M, et al. Stimulation of human somatosensory cortex: tactile and body displacement perception in medial region. Exp Brain Res. 1993, 93(1): 173-176.
23.	Williamson PD, Boon PA, Thadani VM, et al. Parietal lobe epilepsy: dignostic consideration and results of surgery. Ann Neurol, 1992, 31(2): 193-201.
24.	Salanova V, Andermann F, Rasmussen T, et al. Parietal lobe epilepsy: clinical manifestation and outcome in 82 patients treated surgically between 1929 and 1988. Brain, 1995, 118: 607-627.
25.	Abcu-Khalil B. Semiology of mesial frontal and parietal lobe epilepsy. In. Koubeissi MS, Maciunas RJ(editors). Progress in epileptic disorders. Extra temporal lobe epilepsy surgery, Jahn Lebby, France, 2011: 43-63.
26.	Wang WW, Liu Y, Yu H, et al. Three cases of paroxysmal alien limb phenomena due to epileptic seizures and review of literature. Acta Epileptologica, 2021, 4(2): 81-88.
27.	Cascino GD, Hulihan JF, Sharbrough KPJ. Parietal lobe epilepsy: electroclinical correlation and operative autcome. Epilepsia, 1993, 34(3): 522-527.
28.	Montovont A, Kahan P, Catenoix H, et al. Hypermotor seizures in lateral and mesial parietal epilepsy. Epilepsy & Behavior, 2013, 28(3): 408-412.
29.	Rosenow F, Bauer S, Hamer HH. Noninvasive neurophysiology of extratemporal lobe epilepsy: interictal epileptiform discharge, In: Koubeissi MZ, Haciunas RJ (editors). Progress in epileptic disorders. Extratemporal lobe epilepsy surgery. John Lobbey, 2011, France: 95-109.
30.	Eliashiv DS, Elsas SM, Squires K, et al. Ictal magnetic source imaging as a localizing tool in partial epilepsy. Neurology, 2002, 59(10): 1600-1610.
31.	Iwasaki M, Pestana E, Burges RC, et al. Detection of epileptiform activity by human interpretors: Blinded comparison between electroencephalography and magnetoencephalography. Epilepsia, 2005, 46(1): 59-68.
32.	Kakisaka Y, Nakasato N, Haginoya K, et al. Sensorimotor seizure of prediatric onset with unusual posteriorly oriented rolandic spike. Epilepsy Research, 2009, 84(2-3): 153-158.
33.	Kahan P, Hoffmann D, Minotti L, et al. Reappraisal of human vestibular cortex by cortical electrical stimulation study. Ann Neural, 2003, 54(5): 615-624.
34.	Foldvary N, Morris HH. Electrical stimulation of the assoeiated cortex. In: Lüders HO, Noachtor S (editors). Epileptic seizures pathophysiology and clinical semiology, Churchill Livinstone, New York, 2000: 243-247.
35.	Lüders HO, Dinner DS, Morris HH, et al. Electrical stimulation of negative motor area. In: Lüders HO, Noachtor S (editors). Epileptic seizures pathophysiology and clinical semiology. Churchill Livinstone, New York, 2000: 199-219.
36.	Wiest G, Zimprich F, Prayer D, et al. vestibular processing in human paramedion precuneus as shown by electrical cortical stimulation. Neurology, 2004, 62(3): 473-475.
37.	Ho SS, Berkovic S, Newton MR, et al. Parietal lobe epilepsy: Clinical feature and seizure localization by ictal SPECT. Neurology, 1994, 44(12): 2277-2284.
38.	Sakamoto AC, Garzon E. Seizure outcome in extratemporal lobe epilepsies. In: Koubeissi MZ, Maciunas RJ. (editors). Prograss in epileptic disorders. extratemporal lobe epilepsy surgery. John Lebbey, 2011, France: 477-484.

1. Gleisomer U, Kuczaty C, Clusmann H, et al. Neuropsychological results in pediatric patients with epilepsy surgery in the parietal cortex. Epilepsia, 2008, 49(4): 700-704.
2. Balestrinic S, Frandione S, Mai R, et al. Multimodal response induced by cortical stimulation of the parietal lobe: a stereo-electroencephalography study. Brain, 2015, 138(9): 2596-2607.
3. Ristic AJ, Alexopoulos AV, So N, et al. Parietal lobe epilepsy: The great imitator among focal epilepsies. Epileptic Disord, 2012, 14(1): 22-31.
4. Kursun O, Karatas H, Dericioglu N, et al. Refractory lesional parietal lobe epilepsy: clinical, electroencephalographic and neurodiagnostic fimdings. Arch Neuropsychiatry, 2016, 53(3): 213-221.
5. Duncan JS. Occipital and parietal lobe epilepsies. In Sander JW, Rugg-Gunn FJ, Smalls JE(editors). Epilepsy 2009, Chesham Lane, UK, 2009: 155-158.
6. Asodollahi M, Sperling MR, Rabiei AH, et al. Drug-resistant parietal lobe epilepsy: clinical manifestations and surgery outcome. Epileptic Disond, 2017, 19(1): 35-39.
7. Salanova V. Parietal lobe epilepsy. J Clin Neurophysiol, 2012, 29(5): 392-396.
8. Salanova V, Andermann F, Rasmussen T, et al. Tumoural parietal lobe epilepsy: clinical manifestation and outcome in 34 patients treated between 1934 and 1988. Brain, 1995, 118: 1289-1304.
9. Binder DK, Podlogar M, Clusmann H, et al. Surgical treatment of parietal lobe epilepsy. J Neurosurg, 2009, 110(6): 1170-1778.
10. Kim DW, Lee SK, Yun C-H, et al. Parietal lobe epilepsy: the semiology yield of diagnostic workup and surgical outcome. Epilepsia, 2004, 45(6): 641-649.
11. Francione S, Liava A, Mai R, et al. Drug-resistant parietal epilepsy: polymorphic ictal semiology does not preclude good post-surgical outcome. Epileptic Disord, 2015, 17(1): 32-46.
12. Salanova V. Parietal-occiptal lobe epilepsy. In Lüders HO（editor）: Textbook of epilepsy surgery. Informa USA. 2008: 314-319.
13. Engel J, Pedly TA. Epilepsy: a comprehensive textbook, Second edition. Lippin-CoH Williams & walkins, 2009: 2471-2472.
14. Shorvon S, Perucca E, Fish D, et al. The Treatment of Epilepsy. Second edition. Blackwell. USA, 2004: 11.
15. Stephanic C, Lüders HO. Electrical stimulation of invasive electrodes in extratemporal lobe epilepsy. In: Kaubeissi MZ, Haciunas RJ. （editors） Progness in epileptic disorders. extratemporal lobe epilepsy surgery. John Labby, France, 2011: 65-75.
16. Ebner A, Baier H. Electrical stimulation of the somatosensory cortex. In: Lüders HO, Noachtor S（editors）. Epileptic seizures pathophysiology and clinical semiology. Churchill Livinstone, New York, 2000: 187-191.
17. Tuxhorn I, Kerdar MS. Somatosensory Aures. In: Lüder HO, Noachtar s (editors). Epileptic seizures pathophysiology and clinical semiology. Churchill Livinstone, New York, 2000: 182-191.
18. Bartolomi F, Gavart M, Hewett R, et al. Neurol networks underlying parietal lobe seizures: a quential study from intracerebral recordings. Epilepsy Research, 2011, 93(2-3): 164-176.
19. Velasco TR, Sakamoto AC. In: Koubeissi MZ, Maciunas RJ（editors）. Progress in epileptic disorders. Extratemporal lobe eilepsy surgery. Jahn Lebby, France, 2011: 65-75.
20. Salonva V. Parietal lobe epilepsy, In: Vallar G Cosleh HB(editors). Handbook of Clinical Neurology Vol 151 (3rd series), 2018: 413-425.
21. Kamali A, Sair HI, Radmonech A, et al. Decoding the superior parietal lobule connections of the superior longitudinal fasculus/arcuate fasciculus in the human brain. Neuroscience, 2014, 277(26): 577-583.
22. Richer F, Martinez M, Robert M, et al. Stimulation of human somatosensory cortex: tactile and body displacement perception in medial region. Exp Brain Res. 1993, 93(1): 173-176.
23. Williamson PD, Boon PA, Thadani VM, et al. Parietal lobe epilepsy: dignostic consideration and results of surgery. Ann Neurol, 1992, 31(2): 193-201.
24. Salanova V, Andermann F, Rasmussen T, et al. Parietal lobe epilepsy: clinical manifestation and outcome in 82 patients treated surgically between 1929 and 1988. Brain, 1995, 118: 607-627.
25. Abcu-Khalil B. Semiology of mesial frontal and parietal lobe epilepsy. In. Koubeissi MS, Maciunas RJ(editors). Progress in epileptic disorders. Extra temporal lobe epilepsy surgery, Jahn Lebby, France, 2011: 43-63.
26. Wang WW, Liu Y, Yu H, et al. Three cases of paroxysmal alien limb phenomena due to epileptic seizures and review of literature. Acta Epileptologica, 2021, 4(2): 81-88.
27. Cascino GD, Hulihan JF, Sharbrough KPJ. Parietal lobe epilepsy: electroclinical correlation and operative autcome. Epilepsia, 1993, 34(3): 522-527.
28. Montovont A, Kahan P, Catenoix H, et al. Hypermotor seizures in lateral and mesial parietal epilepsy. Epilepsy & Behavior, 2013, 28(3): 408-412.
29. Rosenow F, Bauer S, Hamer HH. Noninvasive neurophysiology of extratemporal lobe epilepsy: interictal epileptiform discharge, In: Koubeissi MZ, Haciunas RJ (editors). Progress in epileptic disorders. Extratemporal lobe epilepsy surgery. John Lobbey, 2011, France: 95-109.
30. Eliashiv DS, Elsas SM, Squires K, et al. Ictal magnetic source imaging as a localizing tool in partial epilepsy. Neurology, 2002, 59(10): 1600-1610.
31. Iwasaki M, Pestana E, Burges RC, et al. Detection of epileptiform activity by human interpretors: Blinded comparison between electroencephalography and magnetoencephalography. Epilepsia, 2005, 46(1): 59-68.
32. Kakisaka Y, Nakasato N, Haginoya K, et al. Sensorimotor seizure of prediatric onset with unusual posteriorly oriented rolandic spike. Epilepsy Research, 2009, 84(2-3): 153-158.
33. Kahan P, Hoffmann D, Minotti L, et al. Reappraisal of human vestibular cortex by cortical electrical stimulation study. Ann Neural, 2003, 54(5): 615-624.
34. Foldvary N, Morris HH. Electrical stimulation of the assoeiated cortex. In: Lüders HO, Noachtor S (editors). Epileptic seizures pathophysiology and clinical semiology, Churchill Livinstone, New York, 2000: 243-247.
35. Lüders HO, Dinner DS, Morris HH, et al. Electrical stimulation of negative motor area. In: Lüders HO, Noachtor S (editors). Epileptic seizures pathophysiology and clinical semiology. Churchill Livinstone, New York, 2000: 199-219.
36. Wiest G, Zimprich F, Prayer D, et al. vestibular processing in human paramedion precuneus as shown by electrical cortical stimulation. Neurology, 2004, 62(3): 473-475.
37. Ho SS, Berkovic S, Newton MR, et al. Parietal lobe epilepsy: Clinical feature and seizure localization by ictal SPECT. Neurology, 1994, 44(12): 2277-2284.
38. Sakamoto AC, Garzon E. Seizure outcome in extratemporal lobe epilepsies. In: Koubeissi MZ, Maciunas RJ. (editors). Prograss in epileptic disorders. extratemporal lobe epilepsy surgery. John Lebbey, 2011, France: 477-484.

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