Localising and lateralising value of ictal piloerection
Localising and lateralising value of ictal piloerection
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DOI：
10.1136/jnnp.2003.023333
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发表时间：
2004-06-01
影响因子：
11
通讯作者：
L端ders, HO
中科院分区：
文献类型：
--
作者：
Loddenkemper, T;Kellinghaus, C;L端ders, HO
背景：竖毛是一种罕见的临床症状描述在癫痫发作。以往的报告表明，颞叶是发作区在许多情况下，这些案件。一个病例系列的结论是，有一个主要的左半球代表发作冷。本研究的目的是评估pillorespicleseizure.Methods的本地化和lateralising值：谁接受视频脑电图（EEG）监测在克利夫兰诊所1994年和2001年之间的患者的医疗记录进行了审查的存在发作立毛。回顾临床病史、体格和神经系统检查、视频EEG数据、神经影像学数据、皮层刺激结果和术后随访，并用于定义致痫区。此外，所有以前报道的情况下，发作立毛review.Results：14例发作立毛被确定（0.4%）。14例患者中有12例患有颞叶癫痫。在7例患者（50%）中，发作位于左半球。与同侧立毛反应相比，5例单侧立毛患者中有4例患同侧颞叶癫痫。3例患者在左颞叶切除术后至少随访12个月，癫痫发作消失。一个同侧的左腿pileprazole反应，同时记录后放电引起在一个病人在直接皮层刺激左侧海马旁gyrus.Conclusions：发作性竖毛是一种罕见的发作表现，主要发生在颞叶癫痫患者。单侧竖毛最常与同侧局灶性癫痫相关。双侧发作性竖毛患者无半球优势。
Background: Piloerection is a rare clinical symptom described during seizures. Previous reports suggested that the temporal lobe is the ictal onset zone in many of these cases. One case series concluded that there is a predominant left hemispheric representation of ictal cold. The aim of this study is to evaluate the localising and lateralising value of pilomotor seizures.Methods: Medical records of patients who underwent video electroencephalogram (EEG) monitoring at the Cleveland Clinic between 1994 and 2001 were reviewed for the presence of ictal piloerection. The clinical history, physical and neurological examination, video EEG data, neuroimaging data, cortical stimulation results, and postoperative follow ups were reviewed and used to define the epileptogenic zone. Additionally, all previously reported cases of ictal piloerection were reviewed.Results: Fourteen patients with ictal piloerection were identified (0.4%). Twelve out of 14 patients had temporal lobe epilepsy. In seven patients (50%), the ictal onset was located in the left hemisphere. Four out of five patients with unilateral ictal piloerection had ipsilateral temporal lobe epilepsy as compared with the ipsilateral side of pilomotor response. Three patients became seizure free after left temporal lobectomy for at least 12 months of follow up. An ipsilateral left leg pilomotor response with simultaneously recorded after-discharges was elicited in one patient during direct cortical stimulation of the left parahippocampal gyrus.Conclusions: Ictal piloerection is a rare ictal manifestation that occurs predominantly in patients with temporal lobe epilepsy. Unilateral piloerection is most frequently associated with ipsilateral focal epilepsy. No hemispheric predominance was found in patients with bilateral ictal piloerection.