GUOQiang , ZHANGWei , LIUXingzhou , WANGXiao , HUXiangshu , HUAGang , CHENGJunxi
  • Epilepsy Center, Guangdong Sanjiu Brain Hospital, Guangzhou 510510, China;
GUOQiang, Email: guoqiang999brain@163.com
Epilepsy; Dorsolateral frontal lobe; Seizure semiology; Stereoelectroencephalography; Surgery; Multi-model
10.7507/2096-0247.20160038
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Objective To investigate characteristics of motor semiology of epileptic seizure originated from dorsolateral frontal lobe. Methods Retrospectively analysis the clinical profiles of patients who were diagnosed dorsolateral frontal lobe epilepsy (FLE) based on stereoelectroencephalography (SEEG) and underwent respective surgeries subsequently. Component of motor semiology in a seizure can be divided into elementary motor (EM, include tonic, versive, clonic, and myoclonic seizures) and complex motor (CM, include automotor, hypermotor, and so on). A Talairach coordinate system was constructed in the sagittal series of MRI images in each case. From the cross point of VAC and the Sylvian Fissure, a line was drawn antero-superiorly, which made an angle of 60° with the AC-PC line, then the frontal lobe could be divided into anterior and posterior portion. The epileptogenic zone, which was defined as ictal onset and early spreading zone in SEEG, was classified into three types, according to the positional relationship of the responding electrodes contacts and the "60° line": the anterior, posterior, and intermediate FLE. The correlation of the components of motor semiology in seizures and the location of the epileptogenic zone was analyzed. Results Five cases (26.3%) were verified as anterior FLE, among which there were 2 of EM, one of CM, and 2 of EM+CM. In 7 cases (36.8%) of intermediate FLE, there were one of EM, none of CM, and 6 of EM+CM. In the rest 7 cases of posterior FLE, there were 6 of EM, none of CM, and one of EM+CM. Compared with the cases that the epileptogenic zone involved anterior portion, the posterior FLE is more likely to present EM seizures (85.7%), and less likely to show CM components (P < 0.05). And Compared with the anterior FLE and posterior FLE, the intermediate FLE is more likely to present EM+CM seizures (85.7%)(P < 0.05). Conclusion The motor seizure semiology of dorsolateral FLE has significant correlation with the localization of the epileptogenic zone. Posterior FLE mainly present a pure elementary motor seizure, and once the epileptogenic zone involved anteriorly beyond the "60° line", the component of complex motor seizure would be seen. Intermediate FLE, as its specialty of transboundary, is more likely to show "comprised semiology" of EM and CM. Construction of the "60° line" with AC-PC coordinate system in the MRI images may play an useful role in semiology analysis in presurgical evaluation of FLE.

Citation： GUOQiang, ZHANGWei, LIUXingzhou, WANGXiao, HUXiangshu, HUAGang, CHENGJunxi. Characteristics of motor semiology of epileptic seizure originated from dorsolateral frontal lobe:an analysis based on stereoelectroencephalography. Journal of Epilepsy, 2016, 2(3): 206-211. doi: 10.7507/2096-0247.20160038 Copy

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