The clinical study of seizures presenting as bilateral synchronized dystonia based on SEEG of patients with epilepsy / 中风与神经疾病杂志

ABSTRACT

@#Objective To investigate the clinical and electrophysiological features of seizures presenting as bilateral synchronized dystonia. Methods A retrospective analysis was performed for patients who underwent surgical evaluation in Guangdong 999 Brain Hospital and Shenzhen Second People's Hospital from January 1,2016 to September 1,2022,and 16 patients with seizures presenting as bilateral synchronized dystonia were enrolled for analysis,among whom there were 11 male patients and 5 female patients,with a mean age of 26±8.97 years and a mean age of onset of 12.6±5.9 years. All patients had detailed records of medical history,scalp VEEG(2-3 times of habitual seizures),head MRI,and heat PET examination. All patients underwent stereotactic electroencephalography(SEEG) implantation(bilateral implantation in 8 patients and ipsilateral implantation in 8 patients),with 2-3 times of habitual seizures observed in all patients. Results Seizures presenting as bilateral synchronized dystonia were often observed in temporal epilepsy,insular epilepsy,or temporal plus epilepsy,and based on SEEG monitoring results,there were 9 patients with temporal-insular plus epilepsy,2 patients with insular epilepsy,and 5 patients with medial temporal lobe epilepsy(MTLE). Bilateral synchronized dystonia was the first or early manifestation of temporal-insular plus epilepsy and insular epilepsy,and in medial temporal lobe epilepsy,bilateral synchronized dystonia was the secondary symptom of automatism or complex motor. SEEG showed that both the medial temporal lobe and the insular lobe were involved in seizures presenting as bilateral synchronized dystonia. Conclusion Seizures presenting as bilateral synchronized dystonia is often observed in temporal-insular plus epilepsy,insular epilepsy,and MTLE,and the involvement of the medial temporal lobe and the insular lobe is required for bilateral synchronized dystonia.