Objective To analyze the clinical imaging and electrophysiological characteristics of patients with intractable parietal lobe epilepsy.Methods A retrospective analysis was conducted on clinical data of 9 patients with intractable parietal lobe epilepsy who underwent preoperative assess-ment and surgical treatment at the Epilepsy Center of the University of Hong Kong-Shenzhen Hospital from January 2021 to February 2023.The information was collected and systematically analyzed,in-cluding demographics,clinical symptoms,electroencephalography(EEG),cranial MRI,positron e-mission tomography--computed tomography(PET-CT)scan results,and clinical outcomes.Results The male-to-female ratio of 9 patients with intractable parietal lobe epilepsy was 5∶4.Among them,6 cases had premonitory symptoms such as loss of space and dizziness,with the most common initial symptoms being confusion and unilateral limb movement.Interictal EEG showed that there were 6 ca-ses with bilateral or unilateral temporal discharge,4 cases with generalized spike-and-wave discharges across all leads.During ictal periods,EEG showed that 8 cases had unilateral temporal or parietal ori-gin,while 1 patient had unknown origin.Among 9 cases,there were 5 cases with negative MRI,2 ca-ses with malacia,1 case with parietal lobe occupancy,and 1 case with cortical thickening of the left marginal gyrus.PET-CT scan results showed that there were 7 cases with bilateral or unilateral parie-tal hypometabolism.Eight cases underwent stereoelectroencephalogram(SEEG)implantation,and 1 case underwent subdural electrode implantation.Among 9 cases,8 cases underwent thermal coagula-tion ablation therapy,and 3 cases underwent epileptogenic lesion resection.The postoperative patho-logical results showed central vascular glioma,embryonic dysplasia neuroepithelial tumor and epilepto-genic lesion,respectively.Post-surgical outcomes for all nine patients were classified as Engel Class I.Conclusion The symptomatic localization characteristics of intractable parietal lobe epilepsy are weak,and relying solely on scalp EEG is prone to misdiagnosis.It is necessary to discuss the compre-hensive localization of epileptic foci in combination with cranial MRI,PET-CT,intracranial electroen-cephalography and MDT.
维普
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