额叶癫痫:百慕大三角

IF 5.8 2区 医学 Q1 CLINICAL NEUROLOGY
Mario Arturo Alonso Vanegas, Kayela Arrotta, Kathryn Davis, Barbara C Jobst, Prakash Kotagal, Annapurna Poduri, Ignacio Valencia
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引用次数: 0

摘要

尽管在影像学、遗传学、外科手术和治疗学方面取得了巨大进步,但额叶癫痫(FLE)仍然是神经学家和癫痫学家面临的一项挑战。本手稿总结了美国癫痫学会年会期间举行的2023年癫痫专家研讨会上讨论的额叶癫痫的最新进展。立体脑电图与临床症状之间的相关性为 FLE 的症状学文献注入了新的活力,使先兆解剖定位更加精确。神经心理学评估可以识别不同的 FLE 认知表型,其中语言是最突出的特定领域障碍。这些测试有助于为这些患者开发心理治疗和认知支持系统。遗传和分子研究发现了与 FLE 易感性相关的特定基因,为靶向治疗提供了前景。高场磁共振成像(MRI)、功能性磁共振成像(fMRI)、脑磁图和多种成像技术的共聚焦等先进的神经成像技术,使致痫区的定位更加精确,为了解额叶癫痫发作的动态神经网络提供了依据。这促进了可在全球范围内使用的指导性治疗手术干预,扩大了这些技术在多人群中的应用。尽管取得了许多进展,但 FLE 患者的预后仍然很差。预后不良的最大决定因素仍然是非病变性 FLE。新技术的进步旨在跨越这些障碍,为 FLE 患者提供更好的生活质量,减轻发作负担,提高认知能力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Frontal Lobe Epilepsy: Bermuda's Triangle.

Despite great progress in imaging, genetics, surgery, and therapeutics, frontal lobe epilepsy (FLE) continues to be a challenge for neurologists and epileptologists. This manuscript summarizes the latest advancements in FLE discussed at the 2023 Epilepsy Specialist Symposium during the American Epilepsy Society Annual meeting. Correlation between stereoelectroencephalography and clinical symptoms has reinvigorated symptomatology literature in FLE, allowing for more precise aura anatomical localization. Neuropsychological assessments permit the identification of different FLE cognitive phenotypes, with language being the most prominent domain-specific impairment. These tests can help develop psychotherapeutic and cognitive support systems for these patients. Genetic and molecular studies have uncovered specific genes associated with FLE susceptibility, offering prospects for targeted therapies. Advanced neuroimaging techniques such as high field magnetic resonance imaging (MRI), functional MRI (fMRI), magnetoencephalography and colocalization of multiple imaging techniques have led to more precise localization of the epileptogenic zone providing insights into the dynamic neural networks underlying frontal lobe seizures. This has facilitated guided therapeutic surgical interventions that can be employed around the world, expanding access of these technologies to multiple populations. Despite many advances, prognosis of FLE remains poor for some patients. The biggest determinant for poor prognosis continues to be nonlesional FLE. Newer technological advancements aim to pass these barriers and offer FLE patients a better quality of life with lower seizure burden and higher cognitive outcomes.

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来源期刊
Epilepsy Currents
Epilepsy Currents CLINICAL NEUROLOGY-
CiteScore
2.40
自引率
5.60%
发文量
88
审稿时长
>12 weeks
期刊介绍: Epilepsy Currents is an open access, bi-monthly current-awareness journal providing reviews, commentaries and abstracts from the world’s literature on the research and treatment of epilepsy. Epilepsy Currents surveys and comments on all important research and developments in a format that is easy to read and reference. Each issue is divided into two main sections: Basic Science and Clinical Science. An outstanding Editorial Board reviews the literature and assigns topics and articles to world experts for comment. In addition, the Editors commission authoritative review articles on important subjects.
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