Launes J, Iivanainen M, Salmi T, Nikkinen P, Lindroth L, Liewendahl K
Department of Neurology, University Central Hospital, Helsinki, Finland.
Acta Neurol Scand. 1992 Dec;86(6):558-62. doi: 10.1111/j.1600-0404.1992.tb05486.x.
Brain perfusion was studied interictally with 99mTc-HM-PAO SPECT in 47 adult patients with partial epilepsy and normal brain CT. Epilepsy was classified as secondarily generalized in 24 patients, as complex partial in 17 patients and as simple partial in 6 patients. In 24 patients good seizure control was not achieved as these patients had a median number of 78 seizures during the preceding month, while in the rest of the patients seizure control was relatively good (less than 6 seizures during preceding month). Local brain hypoperfusion was observed in 41 or 87% of the patients. Hypoperfusion was located close to the EEG foci in 76% and equally often with temporal and frontal foci. Hypoperfusion and the EEG focus were located on the same side in 83%. Hypoperfusion was more frequent in secondarily generalized epilepsy and simple partial epilepsy than in complex partial epilepsy. Left-sided hypoperfusion was especially associated with complex partial epilepsy. It is likely that the significant epileptogenic brain area was revealed in patients with SPECT focus and EEG focus in the same brain area. In one of our patients MRI showed a small temporal lesion which on successful removal was identified as a low-grade oligodendroglioma. Abnormalities of regional brain uptake of HM-PAO demonstrated by SPECT in patients with partial epilepsy and normal brain CT give further information about pathophysiology in partial epilepsy; this may be of use both for selecting appropriate therapy and in presurgical localization of foci.
采用99mTc-HM-PAO单光子发射计算机断层扫描（SPECT）对47例脑CT正常的成年部分性癫痫患者进行发作间期脑灌注研究。癫痫分类为继发性全身性发作24例，复杂部分性发作17例，简单部分性发作6例。24例患者癫痫控制不佳，因为这些患者在前一个月癫痫发作中位数为78次，而其余患者癫痫控制相对较好（前一个月发作少于6次）。41例（87%）患者观察到局部脑灌注不足。76%的灌注不足位于脑电图病灶附近，颞叶和额叶病灶出现的频率相同。83%的灌注不足和脑电图病灶位于同一侧。继发性全身性癫痫和简单部分性癫痫的灌注不足比复杂部分性癫痫更常见。左侧灌注不足尤其与复杂部分性癫痫相关。单光子发射计算机断层扫描（SPECT）和脑电图（EEG）病灶位于同一脑区的患者可能显示出显著的致痫脑区。在我们的一名患者中，磁共振成像（MRI）显示一个小的颞叶病变，成功切除后被确定为低级别少突胶质细胞瘤。脑CT正常的部分性癫痫患者通过单光子发射计算机断层扫描（SPECT）显示的区域脑摄取HM-PAO异常，为部分性癫痫的病理生理学提供了更多信息；这可能有助于选择合适的治疗方法和术前病灶定位。
