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find Keyword "症状学" 9 results
  • Characteristics of motor semiology of epileptic seizure originated from dorsolateral frontal lobe:an analysis based on stereoelectroencephalography

    ObjectiveTo investigate characteristics of motor semiology of epileptic seizure originated from dorsolateral frontal lobe. MethodsRetrospectively analysis the clinical profiles of patients who were diagnosed dorsolateral frontal lobe epilepsy (FLE) based on stereoelectroencephalography (SEEG) and underwent respective surgeries subsequently. Component of motor semiology in a seizure can be divided into elementary motor (EM, include tonic, versive, clonic, and myoclonic seizures) and complex motor (CM, include automotor, hypermotor, and so on). A Talairach coordinate system was constructed in the sagittal series of MRI images in each case. From the cross point of VAC and the Sylvian Fissure, a line was drawn antero-superiorly, which made an angle of 60° with the AC-PC line, then the frontal lobe could be divided into anterior and posterior portion. The epileptogenic zone, which was defined as ictal onset and early spreading zone in SEEG, was classified into three types, according to the positional relationship of the responding electrodes contacts and the "60° line": the anterior, posterior, and intermediate FLE. The correlation of the components of motor semiology in seizures and the location of the epileptogenic zone was analyzed. ResultsFive cases (26.3%) were verified as anterior FLE, among which there were 2 of EM, one of CM, and 2 of EM+CM. In 7 cases (36.8%) of intermediate FLE, there were one of EM, none of CM, and 6 of EM+CM. In the rest 7 cases of posterior FLE, there were 6 of EM, none of CM, and one of EM+CM. Compared with the cases that the epileptogenic zone involved anterior portion, the posterior FLE is more likely to present EM seizures (85.7%), and less likely to show CM components (P < 0.05). And Compared with the anterior FLE and posterior FLE, the intermediate FLE is more likely to present EM+CM seizures (85.7%)(P < 0.05). ConclusionThe motor seizure semiology of dorsolateral FLE has significant correlation with the localization of the epileptogenic zone. Posterior FLE mainly present a pure elementary motor seizure, and once the epileptogenic zone involved anteriorly beyond the "60° line", the component of complex motor seizure would be seen. Intermediate FLE, as its specialty of transboundary, is more likely to show "comprised semiology" of EM and CM. Construction of the "60° line" with AC-PC coordinate system in the MRI images may play an useful role in semiology analysis in presurgical evaluation of FLE.

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  • Seizure arising from ventral motor cortex and DEPDC5 gene mutation

    ObjectiveWe report a special case to explain seizure semiology and epileptogenic network of seizure arising from ventral motor cortex, and to explore Focal cortical dycplasia (FCD) features on MR of epileptic patients with DEPDC5 mutation.MethodsA drug-resistant focal epilepsy patient with DEPDC5 mutation was underwent a detailed presurgical evaluation. The epileptogenic area(EA) was localized with SEEG and removed later by surgery. Related literatures were thoroughly reviewed.ResultsSubtle FCD of ventral branch of inferior precentral sulcus(IPv) on MR(1.5T) was noticed. With SEEG recording, seizure onset zone was detected on IPv with the probable lesion, early spreading to anterior insula, central operculum and ventral precentral gyrus. According to the architectures of ventral motor trend, seizure semiology with evolution from contralateral dystonia to ipsilateral chorea movement could be better comprehended. Seizure was controlled after totally resection on the sites of IPv, anterior insula, and central operculum. Pathological change was FCD type I. Other literatures reported that DEPDC5 mutation related FCD may be located in motor system, and seizure onset could also be in anterior insula cortex besides motor cortex in other SEEG cases.ConclusionsEarly contralateral dystonia and chorea movement could be definite figures of seizure arising from inferior precentral sulcus; DEPDC5 mutation maybe a clue to find subtle FCD in motor cortex.

    Release date:2018-07-18 02:17 Export PDF Favorites Scan
  • Treatment and semeiology analysis of a MRI negative insular epilepsy case

    ObjectiveTo analyse the seizure semeiology of MRI negative insular epilepsy.MethodsA case of patient with insular epilepsy who presented in Epileptic Center, Guangdong 999 Brain Hospital was collected. Related literatures were thoroughly reviewed.ResultsThe patient was diagnosised as insular epilepsy by SEEG and postoperative pathology reported focal cortical dysplasia Ib.ConclusionsThe insula lobe is a part of the limbic system, and the seizure semeiology in insular epilepsy is varied. Seizure semeiology analysis is particularly important in the evaluation of presurgical especially in a MRI negative case. In this paper, we summarized the semeiology characteristics of various parts of insula lobe, and provided some references for the diagnosis and treatment of insular epilepsy.

    Release date:2019-03-21 11:04 Export PDF Favorites Scan
  • 2017年国际抗癫痫联盟癫痫分类评论

    文章对国际抗癫痫联盟(ILAE)2015-2017 年的癫痫、癫痫发作和癫痫持续状态分类进行评论。指出了 2017 年 ILAE 分类的 5 点不足之处,如下:① 分类将症状学的术语与致痫区术语混用;② 分类使用了繁琐且无内涵的术语取代之前简单的且已经被广泛接受的术语;③ 未详细描述癫痫发作的发展过程;④ 在四级癫痫分类中,二级(癫痫分类)与诊断(发作类型)级几乎 100% 重叠;⑤ 分类对于新生儿、成人和癫痫持续状态患者使用不同分类方法,令人感到困惑。作者仍强调验证新 ILAE 分类法的重要性,并认为《Epilepsia》决定应用唯一稿件作为 ILAE 的分类是不成熟的和令人感到遗憾的。

    Release date:2020-07-20 08:13 Export PDF Favorites Scan
  • 基于连接性构筑图谱的岛叶-岛盖癫痫发作症状学亚组

    岛叶-岛盖癫痫发作的特点是多样性的症状学表现,这与岛叶参与多种功能和广泛的连接有关。文章旨在确定其症状学亚组,并将它们与基于连接性构筑进行分区的岛叶-岛盖亚区相联系。回顾性收集来自 3 个癫痫中心 37 例立体定向脑电图(SEEG)检查确定的岛叶-岛盖癫痫发作的一组大样本量患者资料。 基于解剖和功能连接的新的脑网络组图谱(Brainnetome atlas,BNA)被用于分割岛叶-岛盖皮质。仔细阅览症状学和 SEEG 的变化并进行量化,用主成分分析和聚类分析将症状学特征与岛叶-岛盖亚区相关联。基于 BNA 沿前腹侧-后背侧轴确定了 4 个主要的症状学亚组:第 1 组特征是上腹感觉和或协调性姿势性运动行为,伴有或不伴有恐惧或愤怒,涉及前腹侧岛叶和颞叶内侧结构;第 2 组特征是听觉及对称性近端肌或轴肌强直,涉及后腹侧的颞盖;第 3 组特征是口面部和喉部症状,涉及岛叶-岛盖的中间区;第 4 组特征是躯体感觉,继之出现非协调性姿势性运动行为和双侧非对称性强直,涉及后背侧岛叶-岛盖并传播至额叶内侧面。前腹部的癫痫发作主要表现为边缘系统症状学,而更靠后背侧的症状学主要涉及感觉运动系统。主观症状具有特殊的组别区分意义。可根据临床症状学对岛叶-岛盖癫痫发作进行分类,并将其与连接性构筑亚区相关联,它们沿前腹侧-后背侧轴排列,这与细胞构筑的梯度而非岛叶的沟回解剖相一致。这为岛叶-岛盖癫痫的鉴别诊断和术前定位提供了新思路,同时也强调了在确定复杂症状学模式的神经相关性时考虑连接性构筑的重要性。

    Release date:2021-02-27 02:57 Export PDF Favorites Scan
  • ILAE 发作和癫痫分类:对新生儿癫痫发作的调整—ILAE 新生儿癫痫特别工作组制定

    发作是新生儿期最常见的神经急症,与婴儿和儿童不同,癫痫通常是由急性病因引起的诱发性发作,并且可能仅仅表现为脑电图异常。特别需要提出的是,年龄较大的儿童和成人癫痫发作和癫痫的分类方案可能不适用于新生儿发作。因此,国际抗癫痫联盟(ILAE)成立了新生儿癫痫工作组,改进 2017 年 ILAE 发作和癫痫分类,以适用于新生儿。新生儿分类框架强调了脑电图(EEG)在新生儿发作诊断中的作用,并包括了与该年龄组适应的发作类型的分类。发作的类型是由主要的临床特征决定的。许多新生儿发作仅有脑电图表现,没有明显的临床特征;因此,这些都包括在推荐的分类中。没有相关脑电图的临床事件不包括在内。由于新生儿期发作已被证明有局灶性起源的发作,因此没有必要将其划分为局灶性和广泛性。发作可以有运动(自发性、阵挛性、癫痫性痉挛、肌阵挛、强直)、非运动性(自主神经、行为停止)或继发表现。该分类允许用户在对这个年龄组的癫痫发作进行分类时选择详细程度。

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  • 枕叶癫痫症状学研究进展

    枕叶癫痫是指癫痫样异常放电起源于枕叶的癫痫。临床分为原发性枕叶癫痫和继发性枕叶癫痫两种类型,前者又称为儿童良性枕叶癫痫,包括早发型良性儿童枕叶癫痫和晚发型儿童枕叶癫痫,多见于儿童,疗效显著,愈合良好;后者称为症状性枕叶癫痫,常继发于各种脑损伤,如局灶性皮层发育不良、脑外伤、脑出血、脑肿瘤等。有文献报道枕叶癫痫在局灶性癫痫中仅占 2%~13%。常以各种视觉症状和眼部运动症状起始,同时可表现为各种扩散后症状。为进一步加深对枕叶癫痫症状学的认识,本文对枕叶癫痫症状学研究进展作一综述。

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  • 论癫痫症状学

    癫痫的主要症状负担即癫痫发作的临床表现。癫痫症状学产生的神经机制,尤其是复杂行为的神经机制,仍知之甚少。在将癫痫视为网络而非局灶性障碍的框架中,我们可以将症状学视为由一组相互关联的结构动态产生的,这些结构之间按一定规律相互作用,而不仅是简单的解剖定位,从而产生相应的临床表现。这需要我们如何看待致痫区的范式转变,包括从术前评估的角度。症状学是一个关键的数据来源,尽管它在研究中的应用面临着重大的方法学挑战,包括观察者的偏倚和症状学归类的差异。更好地理解症状学分类和病理生理学相关性与癫痫分类系统有关。神经机制以及不同症状学模式的解剖相关知识的进步有助于提高癫痫网络的知识,并可能有助于治疗创新。

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  • 岛叶癫痫的研究进展

    随着立体定向脑电图(Stereoelectroencephalography,SEEG)技术的广泛使用,岛叶癫痫逐渐被认识,其症状学也逐渐被描述清楚。在岛叶癫痫的研究中,主观症状(如上腹部感觉、听觉和躯体感觉等)对于识别岛叶癫痫至关重要,客观的运动成分也比较突出。岛叶癫痫症状学的多样性与其特殊的皮层构筑特点、广泛的功能连接和致痫网络有关。由于岛叶特殊的位置关系,切除手术有一定的风险,SEEG引导下立体定向脑电图引导下射频热凝毁(Radio frequency thermocoagulation,RF-TC)、激光间质热疗法(MRI-guided laser interstitial thermal therapy,LITT)具有接近于切除性手术的有效性,同时具有更高的安全性。这种精准、微创的治疗方法有可能会部分取代传统的切除性外科手术,使更多的癫痫患者获益,但目前来说该技术仍然只是一种尝试。

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