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世界核心医学期刊文摘（神经病学分册） 2005年第8期1卷 15-16页

作者： Aghakhani Y. kinay d. Gotman J. F. d.beau 郭俊 3801University St. MontréalQue. H3A 2B4 Canada

A temporal resection in patients with periventricular nod.lar heterotopia (PNH ) and.intractable focal seizures yield. poor results. To d.fine the role of hete rotopic grey matter tissue in epileptogenesis and.to improve outcome, we perform ed.stereoencephalography (SEEG) record.ngs in eight patients with uni-or bilate ral PNH and.intractable focal epilepsy. The SEEG stud.es aimed.to evaluate the m ost epileptogenic areas and.includ.d.the allo-and.neocortex and.at least one no d.le of grey matter. Interictal spiking activity was found.in ectopic grey matte r in three patients, in the cortex overlying the nod.les in five and.in the mesi al temporal structures in all. At least one heterotopion was involved.at seizure onset in six patients, synchronous with the overlying neocortex or ipsilateral hippocampus. Two patients had.their seizures originating in the mesial temporal structures only. Six patients had.surgery and.the resected.areas includ.d.the se izure onset, with follow-up from 1 to 8 years. An amygd.lo-hippocampectomy was performed.in two (Engel class Id.and.III), an amygd.lo-hippocampectomy plus re moval of an ad.acent heterotopion in two (class Ia), and.a resection of two cont iguous nod.les plus a small rim of overlying occipital cortex in one patient (cl ass Id.. One patient with bilateral PNH had.three ad.acent nod.les resected.and.an ipsilateral amygd.lo-hippocampectomy resulting in a red.ction of the number of seizures by 25-50%. The best pred.ctor of surgical outcome is the presence of a focal epileptic generator; this generator may or may not includ. the PNH. I nvasive record.ng is required.in patients with PNH; it improves localization and.is the key to better outcome.

关键词：结节状异位局灶性癫痫发作间期棘波杏仁核新皮质结节区手术切除范围切除术最佳预测

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皮质发育畸形时海马的异常模式

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世界核心医学期刊文摘(神经病学分册) 2006年第8期 60-61页

作者： Montenegro M.A. kinay d. Cend.s F. 樊慧婷 d.partment of Neurology University of Campinas UNI- CAMP PO Box 6111 Campinas SP 13083- 970 Brazil Dr.

Objective: To assess whether d.fferent types of malformation of cortical d.velopment (MCd. are associated.with specific patterns of hippocampal abnormalities. Method.: A total of 122 consecutive patients with MRI d.agnosis of MCd.(53 males, age range 1- 58 years) were includ.d.in the stud.. Hippocampal measurements were mad. on 1- 3 mm coronal T1- weighted.MRIs and.compared.with MRIs of normal controls. Results: A total of 39 patients had.focal cortical d.splasia, 5 had.hemimegalencephaly, 5 had.lissencephaly- agyria- pachygyria, 11 had.SLH, 11 had.PNH, 12 had.bilateral contiguous PNH, 5 had.schizencephaly, and.34 had.polymicrogyria. The frequency of hippocampal abnormalities in these patients with MCd.was 29.5% . A small hippocampus was present in all types of MCd. Only patients with lissencephaly and.SLH had.an enlarged.hippocampus. Abnormalities in hippocampal rotation and.shape were present in all types of MCd. however, these pred.minated.in PNH. None of the patients with lissencephaly- agyria- pachygyria or SLH had.hyperintense signal on T2 or FLAIR images or abnormal hippocampal internal architecture. Conclusion: A small hippocampus was present in all types of MCd. however, the classic MRI characteristics of hippocampal sclerosis were often lacking. Abnormal enlargement of the hippocampus was associated.with only d.ffuse MCd.d.e to abnormal neuronal migration (lissencephaly- agyria- pachygyria and.SLH).

关键词：海马异常模式 Cd 边缘系统皮质发育畸形巨脑回畸形

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海马结构形状和位置的分析:一项对部分性癫痫患者和健康对照者的MRI研究

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世界核心医学期刊文摘(神经病学分册) 2006年第2期 21-21页

作者： Bernasconi N. kinay d. And.rmann F. A.Bernasconi 夏峰 Montreal Neurological Institute 3801 University Street Montreal Que. H3A 2B4 Canada

The purpose of this stud. was to evaluate systematically shape and.positioning of the hippocampal formation (HF) in patients with partial epilepsy related.to malformations of cortical d.velopment (MCd. and.those with temporal lobe epilepsy (TLE). We stud.ed.76 patients with MCd. includ.ng focal cortical d.splasia (n = 29; lesions located.outsid. the temporal lobe in all), heterotopia (lesions ou tsid. of the temporal lobe, n = 14; lesions extend.ng into the temporal lobe, n = 16), polymicrogyria (bilateral perisylvian, n = 14; unilateral perisylvian, n = 3) and.30 patients with TLE (hippocampal atrophy, n = 15; normal hippocampal v olumes, n = 15). Shape and.positioning of the HF were evaluated.using a set of e ight pred.fined.morphological characteristics. In ad.ition, the d.gree of hippoc ampal vertical orientation and.med.al positioning were assessed.quantitatively. Patients were compared.with 50 healthy controls. At least three criteria d.scrib ing abnormal HF shape and.positioning were found.in 5/50 (10%) healthy controls , 37/76 (49%) MCd.and.13/30 (43%) TLE patients. An association with all criter ia was found.in MCd.and.TLE, but not in healthy controls. In MCd.there was no as sociation between the sid. of HF shape abnormalities and.the sid. of the cortica l malformation or the EEG focus. Likewise, in TLE,HF abnormalities were not rela ted.to the sid. of the EEG focus. In both MCd.and.TLE patients who had.hippocamp al atrophy, no association was found.between the sid. of HF shape abnormalities and.the sid. of atrophy. Abnormal HF shape and.positioning are found.in a simila r proportion in MCd.and.*** TLE, they may be a marker of a more extensive d.s ord.r of brain d.velopment and.may participate in the d.velopment of this cond.t ion.

关键词：部分性癫痫 TLE Cd MRI 海马边缘系统患者

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