Temporal lobe tumor
The incidence of temporal lobe tumor in the brain hemisphere tumors ranked second only to the incidence of frontal lobe tumor. Common tumor as glioma, accounting for 17.96 percent of the total number of intracranial gliomas, followed by meningiomas, accounting for 5.42% of the total number of intracranial meningiomas, while other are usually of metastases occur in this area. More common for adults, gender was not significantly different. Of temporal lobe function is very complicated, some parts of the function is not fully clear, the early course of temporal lobe tumors, multiple non-typical clinical symptoms, diagnosis more difficult in particular tumor is located in the right side, most just showed symptoms of increased intracranial pressure, It is bit rare symptoms and signs, it was also clinically known as the "quiet zone" or "dumb zone", so early diagnosis more difficult.
【Clinical manifestations 】
Early multi-temporal lobe tumor without obvious clinical symptoms. With the progress of course often appear temporal lobe seizures. According to the frequency of epileptic seizures, accompanied by hallucinations. The limitations of seizures evolved into generalized grand mal, seizures and vision to change the interim period, as indicated in 1 / 4-quadrant visual field defect developed to the same sexual hemianopia, Todd longer duration of paralysis, aphasia and mental symptoms such as aggravated, leading to cranial increased internal pressure. Psychomotor-type seizures and progressive multi-line Ministry of tumors to the development of subcortical dissolved. The main clinical symptoms are as follows:
1. Field of vision to change the vision of change often for the early symptoms of temporal lobe tumor, one with sense orientation. In anatomy, the optic radiation under the angle around the lateral ventricle through the temporal lobe. When the tumor is located in the deep temporal lobe, due to impact or damage the optic tract or optic radiation, disease can occur in early contralateral upper quadrant with the anisotropic 1 / 4 of the visual field defect. Cancer continues to increase, the quadrant defect can be developed into a sexual hemianopia with this hemianopia may be complete or incomplete, and both sides of the symmetrical or asymmetrical, such as the rear of temporal lobe tumors are mostly symmetrical, when hemianopia .
2. Sensory aphasia in dominant hemisphere tumor damage to superior temporal gyrus 41 zones, 42 zone, there may be sensory aphasia. Posterior temporal lobe damage, may occur anomic aphasia. This is the diagnosis of temporal lobe tumor, one of the most reliable symptoms. These patients the ability to understand another language and naming ability in items lost, but preserved the ability to speak, though so, but often with typos, speaking the wrong word, or even say more misrepresent the characteristics of the tongue. Severe cases the patient's speech can not be understood, while the patient can not understand the language of others. Amnesia aphasia often as a manifestation of temporal lobe aphasia, the patient named on the item difficulties, but only with the description of the item's features or use instead. When the note item name, the patient can get is correct, confirm the clinical impression is often forgetful aphasia aphasia early part of the performance. In addition, the temporal lobe to the parieto-occipital tumor development, but also often happens that dyslexia, lost writing, computing, and visual loss can not know the symptoms.
3. Seizures of temporal lobe tumor-induced grand mal epilepsy second only to the incidence of frontal lobe tumor. Some patients also appear limited seizures, multiple violations of motor areas because of cancer caused by upward. Temporal lobe epilepsy is characterized by diverse aura symptoms complex, may have conscious trance, speech disorders, psychomotor excitement, emotion and disorientation, hallucinations, delusions, memory impairment and so on. The basic symptoms of memory disorder. Memory as a distant memory, the past memory and present memory. A larger tumor, when a wide range of brain tissue damage that often appears on the time, people, places disorientation. Bilateral medial temporal lobe tumor effects when the performance of the hippocampus and memory impairment for now evident. Some of temporal lobe epilepsy patients, the performance of the places have not been to a sense of familiarity (environmental familiarity), or otherwise feel very strange familiar places (Environmental strange feeling). Some patients showed metamorphopsia (variable as the disease), and as the objects become larger (giant, as the disease) and other visual hallucinations. Representative of auditory cortical areas in the temporal horizontal back to the patient hearing voices, they can hear the sound bigger or smaller, watches and clocks sound, singing, drums, noise and so on. Vestibular cortical auditory hallucination often accompanied by vertigo attacks and paroxysmal tinnitus. Taste the representative district in the lower precentral gyrus, which rarely cause taste disturbance was damaged, but may occur by the stimulation phantom tastes.
Temporal lobe epilepsy may have a variety of pre-precursor, of which the most common olfactory aura, attack the patient suddenly smelled an extremely unpleasant odor or stench. The medial temporal lobe tumors affecting the hippocampus of the hook back, often seen such a precursor, it is known as the "hook back to attack." Patients first be felt on the abdomen to the chest, stomach up a special feeling, is also found in temporal lobe epilepsy, epilepsy in general also have this aura, so no special significance.
Automatic temporal lobe epilepsy syndrome is a common representative of the symptoms is a paroxysmal activity not subject to conscious control, of which the wounding, destruction of objects, self-injury, impulsivity, nudity, etc. who are more excited to see the spirit of , a small number of patients often show a chew, smack, sucking, groping hands, head, eyes and others not attack the purpose of reversing the action. Deep temporal lobe tumors, the abnormal sexual attack can occur, and often accompanied by a fantastic feel, the patient has a sense of fantasy, like dreams, strange feeling, often concurrent with the visual hallucination, it may be returned to childhood, or panic and so on.
4. Psychological symptoms of temporal lobe tumors are also common symptoms of mental disorders, second only to frontal lobe tumor. The main symptoms are personality changes, emotional abnormalities (such as anxiety, depression, panic, anger), paranoid type, memory disorder, mental retardation, apathy and other expressions. A higher incidence of psychiatric symptoms in the dominant hemisphere temporal lobe broad and rapid growth of the tumor.
5. Ataxia temporal gyrus and the temporal next time the rear, through the temporal lobe cerebellar pontine fibers into contact with the cerebellum, therefore, the side of temporal lobe damage can occur ataxia contralateral half-length, it may also occur imbalance, often contralateral to the lesion dumping.
6. Pyramidal tract sign the top of temporal lobe tumor can be oppressive and the frontal and parietal lobes of the lower face and upper extremity movement or sensory impairment, oppression contralateral cerebral peduncle, internal capsule, can cause the same side of the pyramidal tract cancer Zheng, arising from varying degrees of hemiplegia.
7. Other symptoms of temporal lobe tumor can be oppressed by the brain and the oculomotor nerve palsy occurred. Degree of temporal lobe tumor suppression cranial carotid sympathetic plexus, may occur Horner syndrome. The basal ganglia contralateral limb involvement occurs when tremor, chorea, athetosis, paralytic tremor syndrome. Violation of the insula may have a spontaneous visceral pain.
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