Genetic and Related Aetiological Factors in Temporal Lobe Epilepsy
Genetic and Related Aetiological Factors in Temporal Lobe Epilepsy
复制标题
颞叶癫痫的遗传和相关病因
作者：
M. Falconer
在因慢性非肿瘤耐药性颞叶癫痫接受手术的两大系列患者中报告了有关病因学的临床病理学观察。将受影响的颞叶连同海马体、钩回和杏仁核的主要部分一起切除，并进行详细的组织学检查。随后的随访研究表明，患者可分为四个不同的病理组。大约一半患有颞叶内侧硬化，其特征是习惯性癫痫早发，通常在出生后的10岁内，并且有高度阳性的癫痫家族史，并且在婴儿早期长期热性惊厥的发生率很高。五分之一到四分之一出现错构瘤或发育异常，十分之一出现疤痕和梗塞，其余的没有发现具体的病理病变。这三组病例的癫痫发病年龄均较晚，且之前没有发生过热性惊厥。此外，除了一小部分有疤痕和梗塞的患者外，没有出现阳性的癫痫家族史。难产、产后头部受伤或儿童时期的其他杂项疾病等其他因素似乎并不是影响这四组患者癫痫的重要因素。
Clinico‐pathological observations regarding aetiology are reported in two large series of patients submitted to operation for chronic non‐tumorous drug‐resistant temporal lobe epilepsy. The affected temporal lobe was resected in one block together with the major part of the hippocampus, uncus, and amygdala, and was submitted to a detailed histological investigation. Subsequently follow‐up studies showed that the patients could be divided into four distinctive pathological groups. About half had mesial temporal sclerosis which was characterised by an early onset of habitual epilepsy, usually within the 1 st decade of life, and with a high positive family history of epilepsy and high incidence of prolonged febrile convulsions in early infancy. A fifth to a quarter showed hamartomas or developmental anomalies, a tenth showed scars and infarcts, and no specific pathological lesion could be found in the remainder. These three groups of cases each had a later age of onset of epilepsy which had not been preceded by a febrile convulsion. Further, a positive family history of epilepsy was not forthcoming, except in a small group of patients with scars and infarcts. Such other factors as difficult birth, post‐natal head inj ury, or other miscellaneous illnesses in childhood do not appear to have been significant factors influencing epilepsy in these four groups of patients.