Olfactory auras in patients with temporal lobe epilepsy
Olfactory auras in patients with temporal lobe epilepsy
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DOI：
10.1046/j.1528-1157.2003.25902.x
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发表时间：
2003-02-01
期刊：
影响因子：
5.6
通讯作者：
Yiu, CH
中科院分区：
文献类型：
--
作者：
Chen, C;Shih, YH;Yiu, CH
目的：研究颞叶癫痫（TLE）患者的嗅觉先兆。方法：我们回顾了1987年至1998年间在台湾因难治性TLE接受颞叶切除术的217例中国患者的病历。结果：12例（5.5%）患者有嗅觉先兆，其中男性7例，女性5例。除一名患者外，所有患者均描述并描述了不愉快的嗅觉先兆。嗅觉先兆通常与其他先兆合并，最常见的是上腹部隆起、恶心和恐惧的感觉。与味觉幻觉的关联是罕见的，只有一个病人。在神经影像学检查中，11例患者的结构性病变涉及内侧颞叶结构，2例仅涉及杏仁核。组织学诊断包括7名（58.3%）患者的内侧颞区胶质增生，4名（33.3%）患者的肿瘤，1名患者的动静脉畸形。术后，8例患者无癫痫发作。三名患者有罕见的癫痫发作，但是，没有残留的嗅觉aurfication.Conclusions：嗅觉先兆是罕见的TLE。在这项研究中，颞叶内侧硬化症是最常见的病因，而不是肿瘤。内侧颞叶结构，特别是杏仁核，可能在嗅觉先兆的发生中起重要作用。
Purpose: To investigate olfactory auras in patients with temporal lobe epilepsy (TLE).Methods: We reviewed medical records of 217 Chinese patients who underwent temporal lobectomy for medically intractable TLE between 1987 and 1998 in Taiwan. Patients with olfactory auras asked for detailed characteristics of their auras.Results: In all, 12 (5.5%) patients had olfactory auras, seven men and five women. All patients except one described and characterized the unpleasant olfactory auras. Olfactory auras were usually combined with other auras, most frequently sensations of epigastric rising, nausea, and fear. Association with gustatory hallucination was uncommon, in only one patient. On neuroimaging study, 11 patients had structural lesions involving the mesial temporal structures, two exclusively involving the amygdala. Histologic diagnosis included gliosis of the mesial temporal regions in seven (58.3%) patients, neoplasm in four (33.3%) patients, and arteriovenous malformation in one patient. Postoperatively, eight patients were seizure free. Three patients had rare seizures; however, none reported residual olfactory auras.Conclusions: Olfactory auras are infrequent in TLE. In this study, mesial temporal sclerosis is the most common etiology rather than tumors. Mesial temporal structures, especially the amygdala, may play important roles in the genesis of olfactory auras.