The Localizing and Lateralizing Value of Auras in Lesional Partial Epilepsy Patients
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: We investigated the localizing and lateralizing values of auras in patients with lesional partial epilepsy on an outpatient basis. Materials and Methods: A total of 276 subjects were retrospectively selected for this study if they had a unilateral single lobar lesion based on magnetic resonance image (MRI) results, and their scalp electroencephalography (EEG) findings were not discordant with the MRI-defined lobar localization and lateralization. According to the lesion locations,subjects were considered as having mesial temporal (MTLE), lateral temporal (LTLE), frontal (FLE), parietal (PLE), or occipital (OLE) lobe epilepsies. Auras were classified into 13 categories. Results: A hundred and seventy-six subjects (63.8%) had experienced at least one aura. FLE subjects had the fewest number of auras. Epigastric and psychic auras were frequent among MTLE subjects, while visual auras were common in those with PLE and OLE. Somatosensory auras and whole body sensations were more frequent in the subjects with PLE than those without. Autonomic auras were more common in MTLE subjects than in LTLE subjects. Dysphasic auras were more frequently found in left-sided epilepsies. Five pairs of aura categories showed concurrent tendencies, which were the epigastric and autonomic auras, autonomic and emotional auras, visual and vestibular auras, auditory and vestibular auras, and whole-body sensation and auditory auras. Autonomic and emotional auras had a concurrent tendency in left-sided epilepsies, but not in right-sided epilepsies. Conclusion: Our results support the previously known localizing value of auras, and suggest that dysphasic auras and the association of emotional and autonomic auras may have a lateralizing value.
Abstract
Purpose: We investigated the localizing and lateralizing values of auras in patients with lesional partial epilepsy on an outpatient basis. Materials and Methods: A total of 276 subjects were retrospectively selected for this study if they had a unilateral single lobar lesion based on magnetic resonance image (MRI) results, and their scalp electroencephalography (EEG) findings were not discordant with the MRI-defined lobar localization and lateralization. According to the lesion locations,subjects were considered as having mesial temporal (MTLE), lateral temporal (LTLE), frontal (FLE), parietal (PLE), or occipital (OLE) lobe epilepsies. Auras were classified into 13 categories. Results: A hundred and seventy-six subjects (63.8%) had experienced at least one aura. FLE subjects had the fewest number of auras. Epigastric and psychic auras were frequent among MTLE subjects, while visual auras were common in those with PLE and OLE. Somatosensory auras and whole body sensations were more frequent in the subjects with PLE than those without. Autonomic auras were more common in MTLE subjects than in LTLE subjects. Dysphasic auras were more frequently found in left-sided epilepsies. Five pairs of aura categories showed concurrent tendencies, which were the epigastric and autonomic auras, autonomic and emotional auras, visual and vestibular auras, auditory and vestibular auras, and whole-body sensation and auditory auras. Autonomic and emotional auras had a concurrent tendency in left-sided epilepsies, but not in right-sided epilepsies. Conclusion: Our results support the previously known localizing value of auras, and suggest that dysphasic auras and the association of emotional and autonomic auras may have a lateralizing value.
참고문헌 (26)
- Fried I, "The anatomy of epileptic auras: focal pathology and surgical outcome", J Neurosurg, 83, pp.60~66 (1995)
- Palmini A, "The localizing value of auras in partial seizures: a prospective and retrospective study", Neurology, 42, pp.801~808 (1992)
- Schäuble B, "Advances in neuroimaging: management of partial epileptic syndromes", Neurosurg Rev, 26, pp.233~246 (2003)
- Fish DR, "Clinical correlations: MRI and EEG", Magn Reson Imaging, 13, pp.1113~1117 (1995)
- Cross JH, "Early detection of abnormalities in partial epilepsy using magnetic resonance", Arch Dis Child, 69, pp.104~109 (1993)
- Chen C, "Olfactory auras in patients with temporal lobe epilepsy", Epilepsia, 44, pp.257~260 (2003)
- Henkel A, "The localizing value of the abdominal aura and its evolution: a study in focal epilepsies", Neurology, 58, pp.271~276 (2002)
- Nair DR, "Painful auras in focal epilepsy", Neurology, 57, pp.700~702 (2001)
- Bien CG, "Localizing value of epileptic visual auras", Brain, 123(Pt 2), pp.244~253 (2000)
- Acharya V, "Olfactory epileptic auras", Neurology, 51, pp.56~61 (1998)
- Blume WT, "Epilepsy surgery in the posterior cortex", Ann Neurol, 29, pp.638~645 (1991)
- Kim DW, "Parietal lobe epilepsy: the semiology, yield of diagnostic workup, and surgical outcome", Epilepsia, 45, pp.641~649 (2004)
- Gupta AK, "Aura in temporal lobe epilepsy: clinical and electroencephalographic correlation", J Neurol Neurosurg Psychiatry, 46, pp.1079~1083 (1983)
- Currie S, "Clinical course and prognosis of temporal lobe epilepsy. A survey of 666 patients", Brain, 94, pp.173~190 (1971)
- Rasmussen T., "Surgical therapy of frontal lobe epilepsy", Epilepsia, 4, pp.181~198 (1963)
- Feindel W, "Localization of discharge in temporal lobe automatism", AMA Arch Neurol Psychiatry, 72, pp.603~630 (1954)
- Mullan S, "Illusions of comparative interpretation and emotion; production by epileptic discharge and by electrical stimulation in the temporal cortex", AMA Arch Neurol Psychiatry, 81, pp.269~284 (1959)
- Penfield W, "The brain’s record of auditory and visual experience. A final summary and discussion", Brain, 86, pp.595~696 (1963)
- Gloor P, "The role of the limbic system in experiential phenomena of temporal lobe epilepsy", Ann Neurol, 12, pp.129~144 (1982)
- Bancaud J, "Anatomical origin of déjà vu and vivid ‘memories’ in human temporal lobe epilepsy", Brain, 117(Pt 1), pp.71~90 (1994)
- Vignal JP, "The dreamy state: hallucinations of autobiographic memory evoked by temporal lobe stimulations and seizures", Brain, 130(Pt 1), pp.88~99 (2007)
- Ludwig BI, "Clinical ictal patterns in epileptic patients with occipital electroencephalographic foci", Neurology, 25, pp.463~471 (1975)
- Penfield W, "Epilepsy and the functional anatomy of the human brain. 1st ed" (1954), Little Brown
- Brandt T., "Vertigo: its multisensory syndromes. 2nd ed" (2003), Springer
- Lee GP, "Lateralized changes in autonomic arousal during emotional processing in patients with unilateral temporal lobe seizure onset", Int J Neurosci, 112, pp.743~757 (2002)
- Morrow L, "Arousal responses to emotional stimuli and laterality of lesion", Neuropsychologia, 19, pp.65~71 (1981)