限局性病変を有する側頭葉てんかんの前兆  [in Japanese] Aura Differences in Temporal Lobe Epilepsy with Discrete Lesions  [in Japanese]

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Abstract

難治な側頭葉てんかんで手術し、側頭葉に限局性器質病変を有した50症例を対象に、前兆の内容を調べた。いずれも術後2年以上が経過し、手術成績はEngelの分類のclass-Iまたはclass-IIであり、病変の大きさはCTまたはMRI画像上で直径4cm以下を選んだ。対象を、病変が側頭葉外側後部にあるlateral群と側頭葉内側あるいは側頭極にあるpolar-mesial群に分けて検討し、また、病変の側方性(言語優位側か非優位側か)との関係を調べた。その結果、記憶障害性および言語障害性前兆はlateral群に多かった。他の精神性前兆(認知性、感情性)は病変の局在による差異を認めなかった。言語優位側に病変がある症例では前兆は訴えないものが多かった。記憶障害性および感情性前兆は言語非優位側に病変がある症例に多かった。すなわち、病変の局在や側方性により、精神性前兆の内容や頻度が異なることが示された。

We reviewed auras in 50 temporal lobe epilepsy patients with discrete lesions who underwent resection surgery for intractable temporal lobe epilepsy. The size of all lesions was less than 4 cm on CT/MRI. All patients were postoperatively followed for over 2 years, and their seizure outcome was class-I or II according to Engel's criteria. Based on the location of lesions, the patients were classified into three groups; mesial, polar, and lateral. Aura types were compared between the lateral group and the polarmesial group, and its occurrence was compared in patients with lesions at the speech dominant and nondominant sides. Dysmnestic and dysphasic auras were more frequent in the lateral group. The incidence of other psycic auras (cognitive, affective) was not different between the lateral and the polar-mesial groups. Patients with lesions at the speech dominant side tended to have no aura. Dysmnestic and affective auras were more common in the patients with lesions at the nondominant side. These results demonstrate that the location and lateralization of lesions make for a difference in the nature and occurrence of special subtypes of psychic auras.

Journal

  • Journal of the Japan Epilepsy Society

    Journal of the Japan Epilepsy Society 19(2), 117-125, 2001-06-30

    JAPAN EPILEPSY SOCIETY

References:  22

Cited by:  1

Codes

  • NII Article ID (NAID)
    10008556435
  • NII NACSIS-CAT ID (NCID)
    AN10043823
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    09120890
  • Data Source
    CJP  CJPref  J-STAGE 
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