局灶性癫痫继发性强直—阵挛阶段中非对称性强直的临床特征

摘要

目的 分析局灶性癫痫继发强直-阵挛阶段非对称性强直的临床症状学特点.方法 28例患者54次非对称性强直发作,观察两种非对称性强直姿势—M2e和(或)"4"字征,分析其定侧意义、时间相关性及演变特点.结果 ①100%(33/33)M2e出现在致痫区对侧,56%(19/34)"4"字征伸直侧位于致痫灶对侧;② 定侧正确与错误的"4"字征出现时间及持续时间比较(30.3s vs 50.6s,4.6s vs 15.7s),后者差异具有显著性;③M2e转变为定侧正确与定侧错误"4"字征的时间分别为7.5s和15.4s,差异具有显著性.结论 局灶性癫痫中M2e具有定侧意义,而"4"字征在颞叶癫痫中具有较好的定侧价值.%Objective To study the clinical semiology of asymmetric tonic limb posturing in secondarily generalized tonic-clonic seizures .Method A total of fifty-four asymmetric tonic seizures in twenty-eight patients were included for analysis. After quantitative and qualitative analysis of two asymmetric tonic limb posturing-M2e and (or) Figure 4 sign , we evaluated the positive rate of lateralization、Temporal correlation and Evolution characteristics.Results ① All(33/33)M2e posturing was of lateralizing sign which contralateral to the EZ . The extended elbow was contralateral to the side of EZ in 56% (19/34) Figure 4 sign. ② Onset of correct side of Figure 4 sign occurred at a median onset time of 30.3s versus 50.6s in false. The median duration of correct Figure 4 sign was 4.6s versus 15.7s in false. The latter difference was statistically significant. ③ M2e was seen to evolve into Figure 4 sign, The median time of evolution is 7.5s in correct Figure 4 sign versus 15.4s in false. This difference was statistically significant.Conclusion M2e posturing was of lateralizing significance in the patients with localization related epilepsy. The lateralizing value of Figure 4 sign appeared to be quite good in temporal lobe epilepsy.