Sporis Davor, Hajnsek Sanja, Boban Marina, Basić Silvio, Petrović Ratimir, Rados Marko, Babić Tomislav
Department of Neurology, University Hospital Zagreb, Zagreb, Croatia.
Coll Antropol. 2008 Jun;32(2):345-50.
Malformations of cortical development (MCD) have been increasingly recognized as an important cause of intractable epilepsy. The aim of our study was to define epileptogenicity of MCDs by correlating MRI, EEG and semiology of epileptic attacks, and to determine the effect of MCD on drug resistant epilepsy. We also intended to reveal the utility of interictal single photo emission computed tomography (SPECT) in verification of MCD lesions and relative prevalence of different MCDs. Based on interictal EEG finding, semiology of the epileptic attacks and brain magnetic resonance imaging (MRI) "electroclinical epileptogenicity" of MCD was defined. Brain MRI revealed cortical dysplasia (CD) in nine patients, polymicrogyria in four patients, lissencephaly and schizencephaly in one patient each. Three patients had a combination of malformations. The localization of SPECT hypoperfusion corresponded to MCD lesion in ten (66.67%) patients. Electroclinically confirmed epileptogenicity of MCD overlapped with MR and interictal SPECT findings in fourteen (93.3%) and nine (60.0%) patients, respectively. Our study results demonstrated the MCD lesions to be highly epileptogenic and a frequent cause of intractability.
皮质发育畸形（MCD）已日益被认为是难治性癫痫的一个重要病因。我们研究的目的是通过关联癫痫发作的MRI、脑电图（EEG）和症状学来确定MCD的致痫性，并确定MCD对药物难治性癫痫的影响。我们还打算揭示发作间期单光子发射计算机断层扫描（SPECT）在验证MCD病变及不同MCD相对患病率方面的效用。基于发作间期EEG结果、癫痫发作症状学和脑磁共振成像（MRI），定义了MCD的“电临床致痫性”。脑MRI显示9例患者有皮质发育异常（CD），4例患者有多小脑回，各有1例患者有无脑回畸形和脑裂畸形。3例患者有多种畸形组合。SPECT灌注减低的定位在10例（66.67%）患者中与MCD病变相符。电临床证实的MCD致痫性分别在14例（93.3%）和9例（60.0%）患者中与MR及发作间期SPECT结果重叠。我们的研究结果表明MCD病变具有高度致痫性，且是难治性的常见原因。
