眶额区癫痫--有待深入研究的癫痫类型_Journal of Epilepsy

Authors：

 王薇薇 , 吴逊

北京大学第一医院神经内科(北京 100034);

Corresponding author：

王薇薇, Email: wangww@medmail.com.cn

Keywords：

眶额区癫痫; 额叶癫痫; 脑电图; 临床表现

DOI：

10.7507/2096-0247.20170008

Video：

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眶额区位于双侧额叶下方前颅凹中, 嗅束将直回与其他脑回分开。眶额区本身在各脑回间, 以及与额叶凸面及内侧面, 颞叶有广泛的联系。眶额区起源的癫痫少见。发作开始均先出现动作停止、无反应及茫然, 而后根据扩布的不同出现:嗅觉异常、过度运动、头眼偏向同侧或对侧、重复动作等运动症状、自主神经症状, 还可以有难以确定的感觉异常、发笑、似曾相识、视幻觉、自动症。根据临床症状可以分为额叶型、颞叶型及额颞叶型。头皮脑电图很难提供有定位价值的异常, 常为额颞叶甚至双侧额颞叶异常。深部电极尤其是立体脑电图有定侧定位价值。眶额区癫痫几乎均为药物难治性癫痫, 应以外科治疗为主。

Citation： 王薇薇, 吴逊. 眶额区癫痫--有待深入研究的癫痫类型. Journal of Epilepsy, 2017, 3(1): 50-55. doi: 10.7507/2096-0247.20170008 Copy

1.	Mc Gonigal A, Chauvel P. Frontal lobe epilepsy:seizure semiology and presurgial evaluation. Practical Neurology, 2004, 4(7):260-273.
2.	Chang CN, Ojemann LM, Ojemann GA, et al. Seizure of fronto-orbital:a proven case. Epilepsia, 1991, 32(5):487-491.
3.	Cavada C, Schutz W. The mysterious orbitofrontal cortex. Cerebral Cortex, 2000, 10(1):205.
4.	Baud MO, Vulliemoz S, Seeck M. Recurrent secondary generalization in frontal lobe epilepsy:Predictors and a potential link to surgical outcome?. Epilepsia, 2015, 56(11):1454-1462.
5.	O' Muircheartaigh J, Richardson MP. Epilepsy and the frontal lobe. Cortex, 2012, 48(9):144-155.
6.	Jobst BC, Siegel AM, Thadoni VM, et al. Intractable seizure of frontal lobe origin:Clinical characteristics, localizing signs, and results of surgery. Epilepsia, 2000, 41(3):1939-1152.
7.	Bonini F, Mc Gonigal A, Trébuchon A, et al. Frontal lobe seizures:from clinical semiology to lacalization. Epilepsia, 2014, 55(10):264-277.
8.	Bagla R, Skidmore CT. Frontal lobe seizure. The Neuralogist, 2011, 17(6):125-135.
9.	Ludwig B, Marson CA, Van Buren J. Cerebral seizure of probable orbitofrontal origin. Epilepsia, 1975, 16(2):141-158.
10.	Munari C, Bancaud J. Electroclinical symptematology of partial seizure of orbitofrontal origin. In Chauvet P, Delgado-Escueta AV, et al. (edited):Advance in Neurology. Vol 57. 1992, Raven Press Lfd. New York:257-265.
11.	Ajmone-Marson C. Seizure origination from the orbital cortex of the frortal lobe. Epilepsia, 1988, 29(6):208.
12.	Serletis D, Bulacio J, Najm I, et al. Tailored unilobar and multilobar resections for orbitofrontal-plus epilepsy. Neurosurgery, 2014, 37(7):388-397.
13.	Rougier A, Loiseau P. Orbital frontal epilepsy:a case report. J Neurol Neurosur Psychiat, 1988, 51(11):146-157.
14.	Umeoka S, Baba K, Mihara T. Symptomatic laughter in a patient with orbitofrontal seizure:a surgical case with intracranial electroencephalographic study:Case report. Neurosurgy, 2008, 63(10):E1205-1206.
15.	Wang ZI, Ristic AJ, Wang CH, et al. Neuroimaging characteristics of MRI-negative orbitofrontal epilepsy with focus on voxel-based morphometric MRI post-processing. Epilepsia, 2013, 54(9):2195-2203.
16.	Roper SN, Gilmore RL. Orbitofrontal resection for intractable partial seizure. J Epilepsy, 1995, 8(3):146-152.
17.	Comair YG, Paul C, Van Ness C, et al. Neocortical Resections. In:Engel Jr J, Padley TA (eited):Epilesy A Comprehensive Textbook. 2nd edition. Philadelphia, USA. 2008:1874.
18.	Beleza P, Pinho J. Frontal lobe epilepsy. J Clin Neuroscience, 2011, 18(8):593-600.
19.	Pandya DN, Petrides M, Seltzer B, et al. Cerebral Cortex. Architecture, Connections, and The Dual Orgin Concept. Oxford University Press, USA, 2015:33-39, 221-233, 250-253.
20.	Catenoix H, Magnin M, Guénot M, et al. Hippocampal-orbitofrontal connectivity in human:an electrical stimulation study. Clin Neurophysiol, 2005, 116(21):1779-1784.
21.	Tharp BR. Orbital frontal seizures. An unique electroencephalographic and clinical syndrome. Epilepsia, 1972, 13(4):627-642.
22.	Lieb JP, Dasheiff RM, Engel Jr. Role of the frontal lobes in the propagation of mesial temporal lobe seizures. Epilepsia, 1991, 32(6):822-837.
23.	Jones-Gotman M, Zatorre RJ. Odor recognition memory in human:role of right temporal and orbitofrontal regions. Brain & Cognition, 1993, 22(5):182-198.
24.	Smith JR, Sillay K, Winkler P, et al. Orbitofrontal Epilepsy:Electroclinical analysis of surgical cases and literature reciew. Stereotact Funct Neurosurg, 2004, 82(3):20-25.
25.	Van Buren JM, Bucknam CA, Pritchard WL, et al. Autonomic representation in the human orbitotemporal cortex. Neurology, 1961, 11(7):214-224.
26.	Kriegel MF, Roberts DW, Jobst BC. Orbitofrontal and insular epilepsy. J Clin Neurophysiol, 2012, 29(10):385-391.
27.	Rheims S, Ryvlin P, Scherer C, et al. Analysis of clinical pattern and underlying epileptogenic zones of hypermotor seizures. Epilepsia, 2008, 49(12):2030-2040.
28.	Chauvel P, Kliemann F, Vignal JP, et al. The clinical signs and symptoms of frontal lobe seizures. Phenomenology and classification. In:Jasper HH, Riggio S, Goldman-Rakic PS (eited):Epilepsy and The Functional Anatomy of the Fontal Lobe.Reven Press Ltd, New York, USA, 1995:115-126.
29.	Rheims S, Demarquay G, Guénot M, et al. Ipsilateral head deviation related to orbito-frontal and fronto-polar seizures. Epileptic Disord, 2005, 7(3):97-102.
30.	Tinuper P, Bisulli F, Frovini F, et al. Familial frontal lobe epilepsy and its relationship with other noctural paroxymal events. Epilepsia, 2010, 51(Suppl 1):51-53.
31.	La Vega-Talbat M, Duchowny M, Jayakar P. Orbitofrontal seizures presenting with ictal visual hallucinations and interictal psychosis. Pediatr Neurol, 2006, 35(6):78-81.
32.	So NK. Mesial frontal epilepsy. Epilepsia, 1998, 39(Suppl 4):49-61.
33.	Kotagal P, Arunkumar G, Hammel J, et al. Complex partial seizure of frontal lobe onset statistical analysis of ictal semiology. Seizure, 2003, 12(2):268-281.
34.	Munari C, Giallonardo AT, Bancaud J. The problem of orbitofrontal-anterior temporal seizures versus anterior temporal lobe seizure. Epilepsia, 1988, 29(4):208.
35.	Rugg-Gunn FJ, Eriksson SH, Symms MR, et al. Diffuse tensor imaging in refrectory epilepsy. Lancet, 2002, 359(11):1748-1751.
36.	Gavaret M, Badier JM, Marquis P, et al. Electric sauce imaging in frontal lobe epilepsy. J Clin Neurophysiol, 2006, 23(10):358-370.

1. Mc Gonigal A, Chauvel P. Frontal lobe epilepsy:seizure semiology and presurgial evaluation. Practical Neurology, 2004, 4(7):260-273.
2. Chang CN, Ojemann LM, Ojemann GA, et al. Seizure of fronto-orbital:a proven case. Epilepsia, 1991, 32(5):487-491.
3. Cavada C, Schutz W. The mysterious orbitofrontal cortex. Cerebral Cortex, 2000, 10(1):205.
4. Baud MO, Vulliemoz S, Seeck M. Recurrent secondary generalization in frontal lobe epilepsy:Predictors and a potential link to surgical outcome?. Epilepsia, 2015, 56(11):1454-1462.
5. O' Muircheartaigh J, Richardson MP. Epilepsy and the frontal lobe. Cortex, 2012, 48(9):144-155.
6. Jobst BC, Siegel AM, Thadoni VM, et al. Intractable seizure of frontal lobe origin:Clinical characteristics, localizing signs, and results of surgery. Epilepsia, 2000, 41(3):1939-1152.
7. Bonini F, Mc Gonigal A, Trébuchon A, et al. Frontal lobe seizures:from clinical semiology to lacalization. Epilepsia, 2014, 55(10):264-277.
8. Bagla R, Skidmore CT. Frontal lobe seizure. The Neuralogist, 2011, 17(6):125-135.
9. Ludwig B, Marson CA, Van Buren J. Cerebral seizure of probable orbitofrontal origin. Epilepsia, 1975, 16(2):141-158.
10. Munari C, Bancaud J. Electroclinical symptematology of partial seizure of orbitofrontal origin. In Chauvet P, Delgado-Escueta AV, et al. (edited):Advance in Neurology. Vol 57. 1992, Raven Press Lfd. New York:257-265.
11. Ajmone-Marson C. Seizure origination from the orbital cortex of the frortal lobe. Epilepsia, 1988, 29(6):208.
12. Serletis D, Bulacio J, Najm I, et al. Tailored unilobar and multilobar resections for orbitofrontal-plus epilepsy. Neurosurgery, 2014, 37(7):388-397.
13. Rougier A, Loiseau P. Orbital frontal epilepsy:a case report. J Neurol Neurosur Psychiat, 1988, 51(11):146-157.
14. Umeoka S, Baba K, Mihara T. Symptomatic laughter in a patient with orbitofrontal seizure:a surgical case with intracranial electroencephalographic study:Case report. Neurosurgy, 2008, 63(10):E1205-1206.
15. Wang ZI, Ristic AJ, Wang CH, et al. Neuroimaging characteristics of MRI-negative orbitofrontal epilepsy with focus on voxel-based morphometric MRI post-processing. Epilepsia, 2013, 54(9):2195-2203.
16. Roper SN, Gilmore RL. Orbitofrontal resection for intractable partial seizure. J Epilepsy, 1995, 8(3):146-152.
17. Comair YG, Paul C, Van Ness C, et al. Neocortical Resections. In:Engel Jr J, Padley TA (eited):Epilesy A Comprehensive Textbook. 2nd edition. Philadelphia, USA. 2008:1874.
18. Beleza P, Pinho J. Frontal lobe epilepsy. J Clin Neuroscience, 2011, 18(8):593-600.
19. Pandya DN, Petrides M, Seltzer B, et al. Cerebral Cortex. Architecture, Connections, and The Dual Orgin Concept. Oxford University Press, USA, 2015:33-39, 221-233, 250-253.
20. Catenoix H, Magnin M, Guénot M, et al. Hippocampal-orbitofrontal connectivity in human:an electrical stimulation study. Clin Neurophysiol, 2005, 116(21):1779-1784.
21. Tharp BR. Orbital frontal seizures. An unique electroencephalographic and clinical syndrome. Epilepsia, 1972, 13(4):627-642.
22. Lieb JP, Dasheiff RM, Engel Jr. Role of the frontal lobes in the propagation of mesial temporal lobe seizures. Epilepsia, 1991, 32(6):822-837.
23. Jones-Gotman M, Zatorre RJ. Odor recognition memory in human:role of right temporal and orbitofrontal regions. Brain & Cognition, 1993, 22(5):182-198.
24. Smith JR, Sillay K, Winkler P, et al. Orbitofrontal Epilepsy:Electroclinical analysis of surgical cases and literature reciew. Stereotact Funct Neurosurg, 2004, 82(3):20-25.
25. Van Buren JM, Bucknam CA, Pritchard WL, et al. Autonomic representation in the human orbitotemporal cortex. Neurology, 1961, 11(7):214-224.
26. Kriegel MF, Roberts DW, Jobst BC. Orbitofrontal and insular epilepsy. J Clin Neurophysiol, 2012, 29(10):385-391.
27. Rheims S, Ryvlin P, Scherer C, et al. Analysis of clinical pattern and underlying epileptogenic zones of hypermotor seizures. Epilepsia, 2008, 49(12):2030-2040.
28. Chauvel P, Kliemann F, Vignal JP, et al. The clinical signs and symptoms of frontal lobe seizures. Phenomenology and classification. In:Jasper HH, Riggio S, Goldman-Rakic PS (eited):Epilepsy and The Functional Anatomy of the Fontal Lobe.Reven Press Ltd, New York, USA, 1995:115-126.
29. Rheims S, Demarquay G, Guénot M, et al. Ipsilateral head deviation related to orbito-frontal and fronto-polar seizures. Epileptic Disord, 2005, 7(3):97-102.
30. Tinuper P, Bisulli F, Frovini F, et al. Familial frontal lobe epilepsy and its relationship with other noctural paroxymal events. Epilepsia, 2010, 51(Suppl 1):51-53.
31. La Vega-Talbat M, Duchowny M, Jayakar P. Orbitofrontal seizures presenting with ictal visual hallucinations and interictal psychosis. Pediatr Neurol, 2006, 35(6):78-81.
32. So NK. Mesial frontal epilepsy. Epilepsia, 1998, 39(Suppl 4):49-61.
33. Kotagal P, Arunkumar G, Hammel J, et al. Complex partial seizure of frontal lobe onset statistical analysis of ictal semiology. Seizure, 2003, 12(2):268-281.
34. Munari C, Giallonardo AT, Bancaud J. The problem of orbitofrontal-anterior temporal seizures versus anterior temporal lobe seizure. Epilepsia, 1988, 29(4):208.
35. Rugg-Gunn FJ, Eriksson SH, Symms MR, et al. Diffuse tensor imaging in refrectory epilepsy. Lancet, 2002, 359(11):1748-1751.
36. Gavaret M, Badier JM, Marquis P, et al. Electric sauce imaging in frontal lobe epilepsy. J Clin Neurophysiol, 2006, 23(10):358-370.

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