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目的:比较额叶癫痫(FLE)及颞叶癫痫(TLE)的临床症状学区别。方法:纳入2005年10月至2007年3月我院癫痫中心门诊临床诊断为额叶癫痫患者190名,颞叶癫痫患者257名。纳入病例满足发作间期脑电图至少一次具有局限于额叶或颞叶的放电或发作期脑电图明确提示额或颞叶起源;排除所有发作间期脑电图正常、存在多灶或定位不清的脑电异常及影像学检查具有额或颞叶以外的局灶损害者。由两位不知道患者脑电图和影像学结果的临床医生单独分析患者发作情况(先兆、复杂部分发作(CPS)、继发全面强直阵挛发作(SGTC))。用χ2检验统计数据。结果:提示颞叶癫痫最有意义的先兆是经验现象和胃气上升感(P<0.01)。情感表现在TLE中更常见(P<0.05)。口咽自动症与手部自动症是颞叶癫痫患者的典型CPS表现(P<0.01)。而躯体自动症,偏转性强直-肢体与头眼及SGTC、姿势性强直,局部阵挛发作,发作时伴随出声、植物神经症状是额叶癫痫患者的典型CPS表现(P<0.01)。发笑、震颤症状在二类中均可出现,以额叶居多(P<0.05)。言语终止,自言自语,单纯凝视发作对于二者的鉴别意义不大。额叶癫痫组具有两种以上CPS发作的病例更多(P<0.01)。结论:额叶癫痫与颞叶癫痫的症状学特征是不同的,对于临床诊断有重要价值。
Objective: To compare the clinical symptoms of frontal lobe epilepsy (FLE) and temporal lobe epilepsy (TLE). Methods: Totally 190 patients with frontal lobe epilepsy and 257 patients with temporal lobe epilepsy were included in the outpatient department of epilepsy center in our hospital from October 2005 to March 2007. EEG included in the episode met the interictal episode EEG had at least one episode of confinement of the frontal or temporal lobes or episodes of EEG with a clear indication of the extent or origin of the temporal lobe; the exclusion of all interictal EEGs was normal with multifocal or localized Unclear EEG abnormalities and imaging examination with the amount or focal lesions other than temporal lobe. Patient seizures (aura, complex partial episodes (CPS), secondary generalized tonic clonic seizures (SGTC)) were analyzed independently by two clinicians who did not know the EEG and imaging findings of the patients. Χ2 test statistics. RESULTS: The most significant arousal of temporal lobe epilepsy was the experience and gas up feeling (P <0.01). Emotional manifestations were more common in TLE (P <0.05). Ooganism and hand autonomic disorders are typical CPS findings in patients with temporal lobe epilepsy (P <0.01). However, autopsy, deflecting tetanus - limbs and head eyes and SGTC, posture tonic, and local clonus attack, accompanied by the onset of seizures, autonomic symptoms are typical CPS manifestations in patients with frontal lobe epilepsy (P <0.01). Smiles, tremor symptoms can occur in both categories, mostly to the frontal lobe (P <0.05). End of speech, self-talk, simple gaze for the identification of the two little significance. There were more cases of two or more episodes of CPS in the frontal lobe epilepsy group (P <0.01). Conclusion: The symptom characteristics of frontal lobe epilepsy and temporal lobe epilepsy are different and have important value for clinical diagnosis.