Hogan R Edward, Kaiboriboon Kitti, Bertrand Mary E, Rao Venkat, Acharya Jayant
Departments of Neurology, Saint Louis University, St Louis, MO, USA.
Arch Neurol. 2006 Oct;63(10):1419-26. doi: 10.1001/archneur.63.10.1419.
To compare composite subtraction ictal single-photon emission computed tomography coregistered to magnetic resonance imaging (also known as SISCOM) patterns between right and left medial temporal-onset seizures to document neuroanatomical involvement in perfusion patterns.
A retrospective comparative survey.
Epilepsy monitoring unit in a tertiary care referral center.
Subjects with temporal lobe epilepsy (TLE) who underwent ictal single-photon emission computed tomography studies.
Comparison of ictal perfusion pattern changes in subjects with right and left temporal seizures.
Composite subtraction ictal single-photon emission computed tomography coregistered to magnetic resonance images showed similar regions of hyperperfusion change in the ipsilateral anteromedial temporal-corpus striatum-insula region in both groups. In the midbrain reticular formation, there was a significant difference in hyperperfusion between the left and right TLE groups. In addition, the right, but not the left, TLE group shows contralateral hypoperfusion of the temporoparietal junction.
While anteromedial temporal-corpus striatum-insula perfusion patterns are similar, there are brainstem and hemispheric perfusion pattern differences in right and left TLE seizures, confirming pathophysiological differences between the groups. These findings help define neuronal network involvement in TLE seizures, and may explain the differences in clinical symptoms of right and left TLE seizures.
比较右侧和左侧颞叶内侧起始癫痫发作时，与磁共振成像配准的复合减法发作期单光子发射计算机断层扫描（也称为SISCOM）模式，以记录灌注模式中的神经解剖学受累情况。
一项回顾性比较研究。
三级医疗转诊中心的癫痫监测单元。
接受发作期单光子发射计算机断层扫描研究的颞叶癫痫（TLE）患者。
比较右侧和左侧颞叶癫痫发作患者的发作期灌注模式变化。
与磁共振图像配准的复合减法发作期单光子发射计算机断层扫描显示，两组同侧前内侧颞叶-纹状体-脑岛区域的高灌注变化区域相似。在中脑网状结构中，左侧和右侧TLE组之间的高灌注存在显著差异。此外，右侧TLE组（而非左侧）显示颞顶叶交界处对侧低灌注。
虽然前内侧颞叶-纹状体-脑岛灌注模式相似，但右侧和左侧TLE发作在脑干和半球灌注模式上存在差异，证实了两组之间的病理生理差异。这些发现有助于确定TLE发作中神经元网络的受累情况，并可能解释右侧和左侧TLE发作临床症状的差异。
