Marks D A, Katz A, Hoffer P, Spencer S S
Department of Neurology, Yale University School of Medicine, New Haven, CT 06510.
Ann Neurol. 1992 Mar;31(3):250-5. doi: 10.1002/ana.410310304.
We obtained single photon emission computed tomography (SPECT) scans with technetium-99M-hexamethyl-propylene-amine-oxime in 11 patients during 12 extratemporal partial seizures (9 simple partial, 3 complex partial). Ten ictal SPECT studies in 9 patients showed a focal region of hyperperfusion, which agreed with electrical seizure onset in 5 and with clinical seizure localization in 4 in whom ictal electroencephalography was not localized. Contralateral cerebellar and ipsilateral basal ganglia hyperperfusion was seen in 3 patients with a frontal lobe seizure focus. Ictal hyperperfusion was well circumscribed, unlike the diffuse hyperperfusion changes reported during temporal lobe seizures. This observation may indicate a different degree of seizure spread in temporal as opposed to extratemporal epilepsy. Because electroencephalographic localization is often elusive in extratemporal seizures, ictal SPECT may be very helpful for the localization of extratemporal foci.
我们对11例患者在12次颞叶外部分性癫痫发作（9次单纯部分性发作，3次复杂部分性发作）期间进行了锝-99m-六甲基丙烯胺肟单光子发射计算机断层扫描（SPECT）。9例患者的10次发作期SPECT研究显示有一个灌注增强的局灶区域，其中5例与癫痫发作的电起始部位相符，4例与临床癫痫发作定位相符，这4例患者的发作期脑电图未定位。3例额叶癫痫灶患者出现对侧小脑和同侧基底节灌注增强。发作期灌注增强边界清晰，这与颞叶癫痫发作期间报道的弥漫性灌注增强变化不同。这一观察结果可能表明颞叶癫痫与颞叶外癫痫的发作扩散程度不同。由于在颞叶外癫痫发作中脑电图定位常常难以捉摸，发作期SPECT可能对颞叶外病灶的定位非常有帮助。
