Elektrokliničke karakteristike MRI negativnih fokalnih epilepsija: video-EEG monitoring studija
Sažetak
Uvod/Cilj. Epileptogene lezije nose unutrašnji epileptogeni potencijal u svojoj neposrednoj blizini. Jedna trećina bolesnika sa fokalnom epilepsijom nema epileptogenu leziju – negativan nalaz magnetno-rezonantnog snimanja (MRI-). Cilj rada bio je određivanje epileptologene zone ispitivanjem električnih i kliničkih svojstava bolesnika sa MRI-. Metode. Ispitivanjem je obuhvaćeno 180 bolesnika sa fokalnom epilepsijom kojima su analizirani interiktalni i iktalni EEG zapis i semiološke karakteristike kod ukupno 1 712 napada. U slučaju više napada analizirani su najbolje vidljivi napadi na video snimku, sa sekundarnim generalizovanim toničko-kloničkim napadom (GTKN), ukoliko se dogodio. MRI mozga imalo je za cilj istraživanja zone početka napada zabeleženog na EEG zapisu. Elektrokliničke osobine bolesnika sa MRI- upoređivane su sa MRI nalazom bolesnika sa epileptogenom lezijom (MRI+). Rezultati. Jedna epiloptegena lezija je identifikovana kod 68,89% bolesnika [hipokampusna skleroza (HS) kod 58, fokalna kortikalna displazija (FKD) kod 28 bolesnika, druga patologija kod 38 bolesnika]. Bolesnici sa MRI- imali su značajno manje interiktalnih EEG abnormalnosti, a klinički su bili prezentovani značajno češće (p < 0.001) sa sekundarno GTKN. Otvorene oči, hipermotorni napad, bilateralni asimetrični klonički napad, vokalizacija i kontralateralno okretanje tela bili su semiološki znaci viđeni češće kod bolesnika sa MRI- u poređenju sa onima sa MRI+. Bolesnici sa MRI- imali su zajedničke semiološke osobine sa bolesnicima sa FKD, a ne sa bolesnicima sa HS. Zaključak. Epilepsija bolesnika sa MRI- često se prezentuje elektrokliničkom osobinama kakve se viđaju kod epilepsija frontalnog režnja ili epilepsija sa FKD.
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