癫痫患者先兆症状的临床定位意义
Localizing value of epileptic auras
目的 探讨癫痫患者先兆症状的临床定位意义。方法 31例癫痫患者按照有无先兆分为有先兆组(n=19)和无先兆组(n=12),采用独立样本t检验比较两组之间的发病年龄差异有无统计学意义。采用x2检验比较两组之间患者的头颅MRI的异常率及手术有效率差异有无统计学意义。结果 有先兆组的19例患者,分别为精神症状、自主神经症状、躯体感觉、视觉、听觉、头晕共6种先兆,术后先兆症状均消失,以上6种先兆可分别定位于颞叶、颞叶、对侧顶叶或颞叶、枕叶或颞叶、对侧颞叶、颞顶叶。两组间患者的首次发病年龄差异、头颅MRI的异常率差异均无统计学意义。有先兆组和无先兆组患者的手术有效率(分别为15/19和5/12)差异有统计学意义(x2=4.456,P=0.035)。结论 先兆具有一定的定位意义,可以协助判断致痫灶的起源部位,指导外科手术治疗。
更多Objective To study the value of localizing different types of auras. Methods The 31cases with epilepsy were divided into a group with auras (n =19) and a group without auras (n =12).Student t-test was used to analyze difference in onset age in the two groups. The chi-square test was used to analyze the differences in the rates of abnormal brain MRI in two groups and in the efficiency of epileptic surgery between the two groups. ResultsThe 19 patients in aura group had psychiatric symptoms,autonomic symptoms, somatosensory, visual, hearing, and dizziness auras. These auras and EEG and other examines presumebly localized the epilepsy lesions in temporal lobe, temporal lobe, contralateral parietal or temporal lobe, occipital or temporal lobe, contralateral temporal lobe, and temporal-parietal lobe. After the surgery, auras diminished in all these patients. There was no significant differences in onset age and in presence of abnormal brain MRI between the two groups. The percentage of efficient epileptic surgery in the group with aura (15/19) was significantly higher than that in the other group( 5/12, x2 =4. 456, P =0. 035). Conclusions Epileptic aura has significant value in localization of lesion. It can help determine the origins of the epilepsy focal and guide epilepsy surgery.
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