扣带癫痫的电临床特征及手术效果

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior Pub Date : 2025-08-28 DOI:10.1016/j.yebeh.2025.110665

Cuiping Xu , Di Wu , Xiaoming Yan , Xiaohua Zhang , Runshi Gao , Duanyu Ni , Xi Zhang , Xueyuan Wang , Liang Qiao , Kai Ma , Yuping Wang , Tao Yu , Liankun Ren

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引用次数: 0

摘要

背景：扣带癫痫是一种罕见的疾病，具有不同的符号学特征。症状的多样性阐明了扣带回的某些亚区和早期扩散模式的关键累及。了解扣带癫痫的特征对于更好的定位和手术策略是很重要的。目的探讨扣带回局灶性癫痫的电临床特征，总结诊断和手术治疗经验。方法回顾性分析31例癫痫患者，平均年龄21岁，范围2 ~ 48岁，平均癫痫病程10年（范围1 ~ 23年）。我们报告临床符号学、头皮脑电图(EEG)/立体脑电图（SEEG）结果、手术策略和术后随访（平均48个月；范围12-136）。结果12例（38.7%）患者MRI显示病灶范围明确。所有患者均接受了无创术前评估，26例（83.9%）患者接受了SEEG （n = 18）或硬膜下电极（n = 8）的有创记录。头皮脑电动态模式多种多样。前扣带癫痫（ACE）患者表现为同侧额区、额颞区或双额区放电。中扣带癫痫（MCE）患者的初始放电涉及同侧额叶区、颞叶区或中央顶叶区，后扣带癫痫（PCE）患者表现为同侧颞叶区、枕颞叶区、双颞叶顶叶区或全身性放电。继发性广泛性癫痫发作起源于扣带回各亚区。ACE患者表现为过度运动性癫痫发作，包括躯干扭曲、蹬车和连枷。MCE和PCE患者均出现肢体或身体颤抖，PCE患者出现渗渗性癫痫发作。58.1%的患者无癫痫发作，77.4%的患者手术结果满意（Engel I和II）。结论扣状癫痫是一种罕见的癫痫类型，具有多种多样的电临床特征。对于非病变性MRI患者，需要有创记录来确定明确的癫痫发作病灶，1年随访的手术结果是有利的。

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Electroclinical features and surgical outcome of cingulate epilepsy

Background

Cingulate epilepsy is rare and can manifest with variable semiology features. The symptomatic diversity elucidates ictal involvement of certain subregions of the cingulate gyrus and early spread patterns. Knowledge of the features of cingulate epilepsy is important for better localization and surgical strategy.

Objective

The purpose of this study was to characterize the electroclinical features and report our experience in the diagnosis and surgical treatment of patients with focal epilepsy originating from the cingulate gyrus.

Methods

Thirty-one patients with epilepsy were retrospectively analyzed (mean age, 21; range 2–48), who had a mean epilepsy duration of 10 years (range 1–23). We report the clinical semiology, the scalp electroencephalography (EEG)/stereo-electroencephalography (SEEG) findings, surgical strategy, and postoperative follow-up (mean 48 months; range 12–136).

Results

Twelve patients (38.7 %) had circumscribed lesions on magnetic resonance imaging (MRI). All patients underwent noninvasive presurgical evaluation, and 26 (83.9 %) underwent invasive recordings with SEEG (n = 18) or subdural electrodes (n = 8). The ictal patterns of scalp EEG were various. The anterior cingulate epilepsy (ACE) patients showed ipsilateral frontal, frontal-temporal, or bifrontal regions discharges. The ictal discharges involved the ipsilateral frontal, temporal, or central-parietal regions in patients with middle cingulate epilepsy (MCE), and the posterior cingulate epilepsy (PCE) patients showed ipsilateral temporal, occipital-temporal, bitemporal-parietal, or generalized discharges. Secondary generalization seizures originated from each subregion of the cingulate gyrus. The ACE patients showed hypermotor seizures, including twisting trunk, pedaling, and flailing. Limbs or body trembling was observed in both MCE and PCE patients, and dialeptic seizures were observed in PCE patients. 58.1 % of patients were seizure-free, and 77.4 % had a satisfactory surgical outcome (Engel I and II).

Conclusions

Cingulate epilepsy is a rare and diagnostically challenging form of epilepsy with diverse and variable electroclinical features. In patients with non-lesional MRI, invasive recording is required to identify defined seizure focus, and the surgical outcome of 1-year follow-up is favorable.

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来源期刊

Epilepsy & Behavior 医学-行为科学

CiteScore

5.40

自引率

15.40%

发文量

385

审稿时长

43 days

期刊介绍： Epilepsy & Behavior is the fastest-growing international journal uniquely devoted to the rapid dissemination of the most current information available on the behavioral aspects of seizures and epilepsy. Epilepsy & Behavior presents original peer-reviewed articles based on laboratory and clinical research. Topics are drawn from a variety of fields, including clinical neurology, neurosurgery, neuropsychiatry, neuropsychology, neurophysiology, neuropharmacology, and neuroimaging. From September 2012 Epilepsy & Behavior stopped accepting Case Reports for publication in the journal. From this date authors who submit to Epilepsy & Behavior will be offered a transfer or asked to resubmit their Case Reports to its new sister journal, Epilepsy & Behavior Case Reports.