Temporal plus epilepsy定义及其临床特征探究

doi:10.3969/j.issn.1672-6731.2021.07.012

摘要/Abstract

摘要：

内侧颞叶癫是脑网络疾病，多为药物治疗无效者。外科手术后有20%~30%患者仍有发作，其重要原因之一是癫源区超出颞叶内侧，涉及颞叶外侧和颞叶周围区，因此2005年Ryvlin和Kahane提出"TPE"的概念。此后神经电生理尤其是颅内记录、MRI、fMRI和DTI等均证明该类型癫的存在。TPE在临床上具有颞叶内侧及其所涉及区的两种症状。与内侧颞叶癫不同，头皮脑电图异常范围广泛，但不能确定为TPE，颅内电极尤其是立体脑电图是确定TPE必不可少的方法。TPE多为药物难治者，外科手术可全切除癫源区。TPE直译为"颞叶附加癫"，易产生歧义，笔者建议在癫发作分类中增加"多脑叶癫"，包括TPE及其他涉及1个以上脑叶的发作。

关键词: Temporal plus epilepsy (非MeSH词), 多脑叶癫(非MeSH词), 癫,颞叶, 脑电描记术, 综述

Abstract:

Mesial temporal lobe epilepsy (mTLE) is thought to be a network disease, most of them are medical intractable epilepsy. Surgery has benefit outcome, unfortunately, 20%-30% patients with mTLE who undergo surgery fail to achive seizure freedom. One of the causes for failure of surgery is the epileptogenic zone extends from the medial temporal lobe to the lateral and surrending cortices of the temporal lobe. For this reason, Ryvlin and Kahane introduced the conception of temporal plus epilepsy (TPE). Thereafter, the studies of neuroelectrophysiology especially intracranial recordings, MRI, fMRI and DTI have been demenstrated that TPE is a subtype of mTLE. Clinically, the symptoms of TPE should be including both the medial temporal lobe and surrending areas. Scalp EEG recordings are different from the mTLE, since the abnormal findings frenquently exhibit more extensive areas. Therefore, the TPE remain to be determined. Intracranial EEG, epicially SEEG method is especially well-adapted to investigate TPE. TPE is medicinal intractable epilepsy, neurosurgery must be resect the epileptogenic zone totally. If the term temporal plus epilepsy translate to Chinese by word-for-word, what does it means by that? In fact the TPE is a multilobar epilepsy.

Key words: Temporal plus epilepsy (not in MeSH), Multilobe epilepsy (not in MeSH), Epilepsy, temporal lobe, Electroencephalography, Review

王薇薇, 吴逊. Temporal plus epilepsy定义及其临床特征探究[J]. 中国现代神经疾病杂志, 2021, 21(7): 598-605.

WANG Wei-wei, WU Xun. Temporal plus epilepsy: the conception should be attack great importance and inquiring[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2021, 21(7): 598-605.

http://journal11.magtechjournal.com/cjcnn/CN/Y2021/V21/I7/598

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