Clinical study about ictal facial dystonia of medial temporal lobe epilepsy
10.3969/j.issn.1002-0152.2024.10.002
- VernacularTitle:颞叶内侧型癫痫发作期面部肌张力障碍临床研究
- Author:
Sixian LI
1
;
Yuanqing WANG
;
Chen YAO
;
Minhua ZHANG
;
Man ZHANG
;
Xiaodong CAI
Author Information
1. 深圳市第二人民医院功能神经科(深圳 518000)
- Keywords:
Seizure;
Ictal facial dystonia;
Lateralizing value;
Facial emotional expression;
Stereotactic electroen-cephalogram;
Medial temporal lobe epilepsy
- From:
Chinese Journal of Nervous and Mental Diseases
2024;50(10):580-585
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the clinical and electrophysiological characteristics about ictal facial dystonia of medial temporal lobe epilepsy.Method Data was collected from patients with mesial temporal lobe epilepsy originating from unilateral temporal lobe structures through preoperative evaluation at the Functional Neurology Department of the Second People's Hospital of Shenzhen between July 1,2019 and September 1,2023.All patients did not have seizures for at least 1 year after operation.The ictal symptoms of each patient were analyzed and the patients with ictal facial dystonia were selected and the clinical and electrophysiological characteristics of ictal facial dystonia were summarized.Results Nineteen of 47 patients diagnosed as mesial temporal lobe epilepsy had ictal facial dystonia,of which the electroencephalogram starting at the right side in 11 cases and at the left side in 8 cases.Fifteen patients had the symptom in the first 1/3 period of seizure.Fifteen patients had bilateral symmetrical muscle contraction.Thirteen patients showed with negative expression,5 with neutral expression,and 1 with negative or positive expression in different seizures.None of the patient had the drop of the corners of the mouth.Five patients underwent stereotactic-electroencephalogram(SEEG),including 3 patients with bilateral implantation and 2 patients with unilateral implantation.SEEG showed that the medial temporal structure,insula and orbital lobes were all involved in the onset of ictal facial dystonia.Conclusion The medial temporal lobe epilepsy often present ictal facial dystonia in the first 1/3 period of seizure,with bilaterally symmetrically facial contraction,often accompanied by negative expression,but without drop of the corners of the mouth.The lateralization value of ictal facial dystonia is limited and this symptom involves a wide brain network structure.
