Theodore William H, Kelley Kathey, Toczek Maria T, Gaillard William D
NIH, Clinical Epilepsy Section, Bethesda, Maryland 20892, USA.
Epilepsia. 2004 Mar;45(3):276-9. doi: 10.1111/j.0013-9580.2004.51803.x.
Studies using magnetic resonance imaging have shown that reduced hippocampal volume is associated with a history of febrile seizures, the duration of epilepsy, and the number of generalized tonic-clonic seizures. It is uncertain whether these factors have the same influence on functional as on structural measures of the integrity of the epileptogenic zone.
We used positron emission tomography (PET) with fluorine 18 2-deoxyglucose to study 91 patients with temporal lobe seizure foci localized by ictal video-EEG. PET was performed in the awake interictal resting state with ears plugged and eyes patched. We recorded surface EEG during injection (5 mCi) and the 30-min uptake period. We used a standard template to analyze PET scans.
A significant negative relation was found between the duration of epilepsy and hippocampal glucose metabolism ipsilateral to the epileptic focus. Patients with a history of either any febrile seizures, or complex, or prolonged febrile seizures, did not have greater hypometabolism ipsilateral to the epileptic focus than did patients without a febrile seizure history. We found no effect of generalized tonic-clonic seizure history.
Longer epilepsy duration is associated with greater hypometabolism, suggesting that epilepsy is a progressive disease.
利用磁共振成像的研究表明，海马体体积减小与热性惊厥病史、癫痫持续时间以及全身强直阵挛性发作次数有关。尚不确定这些因素对癫痫发作区完整性的功能指标和结构指标的影响是否相同。
我们使用氟代脱氧葡萄糖正电子发射断层扫描（PET）对91例经发作期视频脑电图定位颞叶癫痫病灶的患者进行研究。PET检查在清醒的发作间期静息状态下进行，耳塞住耳朵，眼睛蒙住。在注射（5毫居里）及30分钟摄取期记录头皮脑电图。我们使用标准模板分析PET扫描图像。
癫痫持续时间与癫痫病灶同侧海马体葡萄糖代谢之间存在显著负相关。有任何热性惊厥病史、复杂性热性惊厥病史或长时间热性惊厥病史的患者，其癫痫病灶同侧的代谢减低情况并不比无热性惊厥病史的患者更严重。我们未发现全身强直阵挛性发作病史有任何影响。
癫痫持续时间越长，代谢减低越明显，提示癫痫是一种进行性疾病。
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