114例特发性夜间额叶癫痫的临床及脑电图研究

目的 分析114例特发性夜间额叶癫痫(NFLE)患者的临床特征、脑电图和神经影像学表现、治疗效果及预后.方法 回顾性分析解放军总医院癫痫门诊自1999年6月至2007年1月收治的114例NFLE患者的临床资料.结果 NFLE以夜间成串的偏转性、姿势性强直及过度运动发作为最显著的临床特征;本组22.9%清醒发作间期常规脑电图及28%清醒发作间期动态脑电图可见额叶癫痫样放电,38%睡眠发作间期动态脑电图可见额叶癫痫样放电,66.7%发作期脑电图可见额叶癫痫样放电;79.8%药物治疗有效,其中29.7%可完全控制.结论 NTLE具有特征性的临床发作特点,发作期及发作间期脑电图改变阳性率不高,临床上应注意鉴别.额叶癫痫容易在夜间发作,睡眠腩电图对NFLE具有重要的诊断价值.

Clinical and electroencephalographic study of idiopathic nocturnal frontal lobe epllepsy

Objective To analyze the characteristics,electroencephalographic(EEG)features,neuroimaging findings,therapeutic effects and prognoses of 114 cases of idiopathic nocturnal frontal lobe epilepsy (NFLE). Methods The clinical data of 114 patients with idiopathic NHLE admitted in the epilepsy outpatient department from June,1999 to January,2007 were collected and analyzed. Results Idiopathic NFLE was clinically characterized by nocturnal clustered,postural or dystonic seizures and complex motor activities.The interictal routine EEG in 22.9% and dynamic EEG in 28% of the cases in wakefuIness and the interictal dynamic EEG in 38% of tbe cases in sleep showed frontal lobe epileptiform discharge,which was found in the EEG during seizure attacks in66.7% of the cases.Drug therapy was effeclive in 79.8% of the cases.with 29.7% of the cases showing complete seizure control. Conclusions Idiopathic NFLE has distinct clinical features wim relatively low rate of EEG abnormality during seizure attack or the interictal period.Frontal lobe epilepsy is more likely to occur in sleep,and sleep EEG is therefore of much importance in the diagnosis of idiopathic NFLE.