De Reuck J, Vonck K, Santens P, Boon P, De Bleecker J, Strijckmans K, Lemahieu I
Department of Neurology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium.
J Neurol Sci. 2000 Dec 1;181(1-2):13-8. doi: 10.1016/s0022-510x(00)00382-8.
The pathogenesis of late-onset epileptic seizures after thrombo-embolic cerebral infarction is poorly understood. Our previous positron emission tomographic (PET) studies with 15O have demonstrated that post-apoplectic epilepsy is associated with more severe brain ischemia, but we were unable to determine if this was the cause or the consequence of the seizures. Using cobalt-55 (55Co) as PET tracer we can now distinguish recurrent, recent infarction in patients with a previous old infarct in the same vascular territory. In seven out of twelve patients with post-apoplectic seizures an increased uptake of 55Co was observed in the border area and in two of them also within the old infarct core. In the control group, composed of eight seizure-free patients with also an old infarct involving the cortical territory of the middle cerebral artery, no increase in 55Co uptake was observed on PET examination. The present study indicates that in a significant number of patients late-onset epilepsy is the clinical expression of recurrent strokes, occurring in the same vascular territory.
血栓栓塞性脑梗塞后迟发性癫痫发作的发病机制尚不清楚。我们之前使用15O进行的正电子发射断层扫描（PET）研究表明，中风后癫痫与更严重的脑缺血有关，但我们无法确定这是癫痫发作的原因还是结果。使用钴-55（55Co）作为PET示踪剂，我们现在可以区分同一血管区域先前有陈旧性梗塞的患者的复发性近期梗塞。在12例中风后癫痫患者中，有7例在边界区域观察到55Co摄取增加，其中2例在陈旧性梗塞核心内也观察到55Co摄取增加。在由8例无癫痫发作且有涉及大脑中动脉皮质区域的陈旧性梗塞患者组成的对照组中，PET检查未观察到55Co摄取增加。本研究表明，在相当数量的患者中，迟发性癫痫是在同一血管区域发生的复发性中风的临床表现。
