The natural history of mesial temporal lobe epilepsy
The natural history of mesial temporal lobe epilepsy
复制标题
内侧颞叶癫痫的自然病程
DOI：
10.1097/wco.0b013e3282f36ccd
复制
发表时间：
2008-04-01
影响因子：
4.8
通讯作者：
Berg, Anne T.
中科院分区：
文献类型：
--
作者：
Berg, Anne T.
综述目的内侧颞叶癫痫是癫痫手术最常见的适应症，但对其从最初发病以来的“自然”病史知之甚少。该综述考虑了现有的证据和我们目前对该主题的了解中的差距。 最新发现 尽管通常在成年后进行手术治疗，但大多数难治性内侧颞叶癫痫患者最初发病于儿童期和青春期。这种疾病的病程很复杂，一开始可能看起来相对良性，后来才出现顽固性癫痫发作。内侧颞叶癫痫的早期诊断非常困难，因为几乎没有 MRI 相关数据，即海马萎缩，这种病变似乎随着时间的推移而发展，并且在初次发病时很少出现。由于可能有许多不同的实体位于颞区，并且最初彼此之间没有明显区分，因此早期诊断变得更加复杂。总结要进一步了解内侧颞叶癫痫，需要齐心协力，从发病开始就准确地描述癫痫特征，并记录其长期病程。还需要更好地认识目前被归为颞叶癫痫的特定亚型。
Purpose of reviewMesial temporal lobe epilepsy is the most common indication for epilepsy surgery, yet little is known about its 'natural' history from initial onset. The review considers the available evidence and gaps in our current knowledge of the subject.Recent findingsAlthough usually surgically treated in adulthood, the majority of people with refractory mesial temporal lobe epilepsy have their initial onset in childhood and adolescence. The course of the disorder is complex and may appear relatively benign at first with intractable seizures emerging only later. Early diagnosis of mesial temporal lobe epilepsy is made difficult due to the near absence of its MRI correlate, i.e. hippocampal atrophy, a lesion that seems to develop over time and is rarely present at initial onset. Early diagnosis is further complicated by the fact that there are likely many different entities that are localized to the temporal regions and are not clearly differentiated from each other initially.SummaryAdvances in understanding mesial temporal lobe epilepsy will require concerted efforts to characterize epilepsy with precision from onset and document its course over prolonged periods of time. Better recognition of specific subtypes currently lumped together as temporal lobe epilepsy is also needed.