发作期头偏转现象对颞叶内侧型癫痫致痫区的定侧价值

摘要

Objective To investigate the lateralizing value of head deviation(HD) during complex partial seizures (CPS) in patients with refractory mesial temporal lobe epilepsy (mTLE).Methods Presurgical videotypes of 43 patients who were seizure-free for at least one year after temporal lobectomy were retrospectively reviewed.Attention was paid to the relationship between time and type of HD and the side of epileptogenic zone.Results HD was seen in 88 CPS from 43 patients who had total 206 CPS with or without secondary generalization.Both versive and non-versive HD displayed high positive predictive value (83％ (33/40) and 88％ (22/25)) for localization of an ipsilateral and contralateral seizure onset,respectively.Conclusion Both non-versive HD and versive HID during CPS in patients with mTLE are reliable lateralizing signs that can complement other diagnostic modalities in presurgical evaluation.%目的 探讨复杂部分发作(CPS)期头偏转现象在颞叶内侧型癫痫(mTLE)致痫区定侧中的应用价值.方法 对43例确诊mTLE患者的术前发作录像进行回顾性分析.重点关注不同类型头偏转现象与致痫区侧别的关系.结果 在43例患者中,共有206次伴有或不伴有继发大发作的CPS,其中88次发作出现了头偏转现象.轻度头偏转和明显头偏转对致痫区定侧的阳性预测值分别为83％ (33/40)和88％ (22/25),分别提示致痫区位于同侧半球和对侧半球.结论 在mTLE患者中,CPS期轻度头偏转和明显头偏转均可较好地定侧致痫区,在术前致痫区定位评估中可参考使用.