目的:研究肿瘤相关癫痫患者嗅觉光环的特征。
方法:我们进行了单中心,在乌迪内大学医院神经外科病房接受手术的患者的回顾性研究(乌迪内,意大利),2010年1月1日至2019年1月1日,涉及颞叶和脑岛的原发性脑肿瘤(PBT)。所有患者均受到肿瘤相关癫痫的影响;研究组也表现出嗅觉光环。我们收集了神经放射学,来自患者医学图表的神经心理学和神经生理学数据。
结果:MRI数据的减法分析显示左侧嗅觉皮层的最大病变重叠,左右海马,左杏仁核,右罗兰盖,右额下回和右颞中回。嗅觉光环的存在不影响癫痫发作结果(p=0.500)或手术后肿瘤复发(p=0.185)。光环的类型(初级与复杂),还,不影响癫痫发作控制(p=0.222)。
结论:在存在嗅觉光环的情况下,前部和中部颞区主要受累,比如嗅觉皮层,杏仁核,和前海马,和右罗兰管壳一起,右额下回和右颞中回,表明它们在嗅觉光环的起源中可能发挥作用。手术后癫痫发作结果和疾病复发不受嗅觉光环的存在和类型的影响。
结论:嗅觉光环是罕见事件,然而,它们可能经常被患者低估,被临床医生调查不足,即使它们的出现可以代表一个有用的本地化工具。
OBJECTIVE: To characterize a profile for patients with tumor-related epilepsy presenting olfactory auras.
METHODS: We conducted a monocentric, retrospective study on patients who underwent surgery in the Neurosurgery Unit of Udine University Hospital (Udine, Italy), between the 1st of January 2010 and the 1st of January 2019, for primary brain tumors (PBTs) involving the temporal lobe and the insula. All patients were affected by tumor-related epilepsy; the study group presented olfactory auras as well. We collected neuroradiological, neuropsychological and neurophysiological data from patients\' medical charts.
RESULTS: The subtraction analysis of MRI data shows maximum lesion overlay in left olfactory cortex, left and right hippocampus, left amygdala, right rolandic operculum, right inferior frontal gyrus and right middle temporal gyrus. The presence of olfactory auras did not influence seizure outcome (p = 0.500) or tumor recurrence after surgery (p = 0.185). The type of auras (elementary vs. complex), also, did not influence seizure control (p = 0.222).
CONCLUSIONS: In presence of olfactory auras, anterior and mesial temporal regions are mainly involved, such as olfactory cortex, amygdala, and anterior hippocampus, together with right rolandic operculum, right inferior frontal gyrus and right middle temporal gyrus, suggesting their possible role in the genesis of olfactory auras. Post-surgical seizure outcome and disease relapse are not influenced by neither the presence nor the type of olfactory auras.
CONCLUSIONS: Olfactory auras are rare event, however they may be often underestimated by the patients and under-investigated by the clinicians, even when their occurrence can represent a useful localizing tool.