Abstract:
CONCLUSIONS: In this review, the semiology, and characteristics of noninvasive investigations suggestive of anterior cingulate and anterior midcingulate epilepsy are detailed by the authors. The clinical presentation is representative of a recently recognized rostrocaudal gradient of functional connectivity with seizures of the anterior cingulate cortex manifesting emotional and interoceptive aura followed by a hyperkinetic or complex motor seizures. The few reports of anterior midcingulate epilepsy show a trend toward a higher proportion of sensory auras and premotor semiology. Ictal pouting, vocalizations, and, in particular, laughter are strong indicators of epilepsy arising or spreading to this region. Although scalp EEG was traditionally thought to provide little information, the data provided in this review demonstrate that most patients will have abnormalities over the frontal or frontotemporal regions. Frontotemporal abnormalities at least interictally provide valuable information regarding lateralization. The etiology of epilepsy arising from the anterior cingulate region seems to be most frequently secondary to focal cortical dysplasia (FCD), followed by neoplasms and vascular lesions, particularly cavernomas, although one cannot rule out a publication bias. Findings of nuclear medicine imaging is seldomly reported but both positron emission tomography and ictal single-photon computed tomography can identify the generator or the network often showing abnormalities extending to the frontal regions. The few available magnetoencephalography (MEG) studies reveal mixed results, sometimes providing false lateralization of the focus. Anterior cingulate epilepsy is difficult to recognize, but the features summarized in this review should prompt suspicion in clinical practice.
摘要:
结论:在这篇综述中,符号学,作者详细介绍了提示前扣带和前扣带中癫痫的非侵入性检查的特征。临床表现代表了最近认识到的功能连接的rostrocautal梯度,伴有前扣带回皮质的癫痫发作,表现出情绪和感觉先兆,然后是运动过度或复杂的运动性癫痫发作。少数关于前中扣带癫痫的报道显示,感觉光环和运动前符号学的比例更高。ctal嘴,发声,and,特别是,笑声是癫痫出现或传播到这个地区的强烈迹象。尽管传统上认为头皮脑电图提供的信息很少,本综述提供的数据表明,大多数患者会出现额叶或额颞叶区域的异常.额颞叶异常至少在内部提供了有关偏侧化的有价值的信息。由前扣带区域引起的癫痫的病因似乎最常见的是继发于局灶性皮质发育不良(FCD),其次是肿瘤和血管病变,尤其是海绵体瘤,尽管不能排除出版偏见。很少报道核医学成像的发现,但正电子发射断层扫描和发作性单光子计算机断层扫描都可以识别发生器或网络,通常显示异常延伸到额叶区域。少数可用的脑磁图(MEG)研究揭示了混合的结果,有时会提供焦点的虚假偏侧化。前扣带回癫痫难以识别,但是本综述中总结的特征应引起临床实践的怀疑。