Ide M, Mizukami K, Suzuki T, Shiraishi H
Division of Psychiatry, University of Tsukuba Hospital, Ibaraki, Japan.
Psychiatry Clin Neurosci. 2000 Oct;54(5):595-7. doi: 10.1046/j.1440-1819.2000.00759.x.
A 26-year-old female presented psychomotor seizures, deja vu and amnestic syndrome after meningitis at the age of 14 years. Repeated electroencephalograms (EEG) demonstrated occasional spikes localized in the right temporal region in addition to a considerable amount of theta waves mainly in the right fronto-temporal region. Single photon emission computed tomography (SPECT) showed a marked hypoperfusion corresponding to the region in which the EEG showed abnormal findings, although magnetic resonance imaging (MRI) demonstrated no abnormal findings associated with the clinical features. Treatment with clonazepam in addition to sodium valproate resulted in a remarkable improvement of clinical symptoms (i.e. psychomotor seizures and deja vu), as well as of the EEG and SPECT findings. The present study suggests that SPECT is a useful method not only to determine the localization of regions associated with temporal lobe epilepsy but also to evaluate the effect of treatment in temporal lobe epilepsy.
一名26岁女性在14岁患脑膜炎后出现精神运动性癫痫发作、似曾相识感和遗忘综合征。多次脑电图(EEG)检查除了在右额颞区有大量主要为θ波外,还显示偶尔有尖波定位于右侧颞区。单光子发射计算机断层扫描(SPECT)显示与EEG显示异常结果的区域相对应的明显灌注减低,尽管磁共振成像(MRI)未显示与临床特征相关的异常发现。除丙戊酸钠外,使用氯硝西泮治疗使临床症状(即精神运动性癫痫发作和似曾相识感)以及EEG和SPECT结果有显著改善。本研究表明,SPECT不仅是确定与颞叶癫痫相关区域定位的有用方法,也是评估颞叶癫痫治疗效果的有用方法。