Overview of parietal lobe epilepsy
Parietal lobe epilepsy is characterized by predominantly sensory seizures secondary to generalized seizures, often manifesting as complex partial seizures if the epileptic discharges extend beyond the parietal lobe. Seizures are characterized by a number of sensory symptoms, such as numbness and electrocution. The most commonly affected areas are in the cortical representation, and there may be tongue twitching, tongue stiffness or coldness, and facial sensory phenomena may occur on both sides of the face. Occasionally, a feeling of abdominal sinking, obstruction, or nausea may occur, and in a few cases, pain may be present. Dominant parietal seizures may cause a variety of perceptual or conductive language deficits, and non-dominant parietal seizures may be seen with variable visual hallucinations, such as distortion of distortions, shortening and lengthening.
Etiology
The most common cause is a space-occupying lesion. Most of the attacks with parietal lobe onset are related to tumors, the most common being astrocytomas, followed by meningiomas, and to a lesser extent synaptic glioblastomas, hemangiomas and metastatic carcinomas, while the others are birth injuries, post-inflammatory scarring, cerebrovascular diseases, metabolic encephalopathies and hereditary disorders, and a small number of them are of unknown cause.
Symptoms
The parietal lobe includes the posterior central gyrus and inferior parietal gyrus, and the medial aspect of the parietal lobe is the posterior part of the paracentral lobule with the precuneus. Epileptic seizures manifest differently in different parts of the parietal lobe: irritant lesions in the posterior central gyrus and inferior parietal gyrus may present as corticosensory epilepsy with tingling and electric shock sensations, or as limb agnosia or phantom polydactyly. Involvement of the inferior lateral parietal lobe often presents with a sinking sensation in the abdomen, stuffiness, nausea, and may be characterized by a burning sensation. Parietal insula seizures may present with acidic and bitter taste sensations. Parietal lobe visual seizures are characterized by visual hallucinations and optical illusions, with visual objects becoming larger, smaller, or more distant, and distorted images.
Examination
1. Routine blood, urine, stool examination and blood sugar, electrolyte (calcium, phosphorus) measurement.
2. Electroencephalogram (EEG) examination: EEG in the interictal period is mostly normal or shows focal slow waves. In the seizure period, there are limited spike-slow complex wave bursts in the parietal region.
3. Neuroimaging CT and MRI are important for the diagnosis of primary etiology.
Diagnosis
Diagnosis can be made according to the etiology, clinical manifestations and relevant examinations.
Treatment
1. Drug treatment
Commonly used drugs include phenobarbital, phenytoin sodium, paracetamol, etc. Surgery is considered when drug treatment is ineffective.
2.Surgery
Surgery can be performed as lesion excision, multifocal subchondroplasty of the epileptogenic zone or a combination of both. Focal subchondroplasty or a combination of both.