Pawlik G, Holthoff V A, Kessler J, Rudolf J, Hebold I R, Löttgen J, Heiss W D
Max-Planck-Institut für neurologische Forschung, Cologne University Hospital, Department of Neurology and Psychiatry, PET Laboratory, Köln, Federal Republic of Germany.
Acta Neurochir Suppl (Wien). 1990;50:84-7. doi: 10.1007/978-3-7091-9104-0_17.
Using the 2-[F-18]fluorodeoxyglucose method, 213 positron emission tomographic (PET) studies of local brain glucose metabolism (CMRglu) were performed in 124 patients with various forms of epilepsy. Interictal PET scans of primary epileptics typically showed some global metabolic depression and decreased functional activity of insular, basal and anterior temporal cortex. Epilepsia partialis continua Kozevnikov was characterized by hypo- or hyper-metabolism of perirolandic cortex. Tuberous sclerosis was distinguished by neocortical foci of significantly decreased glucose consumption. Even in the interictal resting state, with regard to sensitivity (greater than 90%) and accuracy of focus localization. PET was superior to other diagnostic methods in typical temporal lobe epilepsy. Averaging 23% below normal CMRglu, the majority of hypometabolic foci were found in mesial temporal structures. Improved distinction between the epileptogenic area and the surrounding tissue showing comparatively normal functional responsiveness, was achieved by psychophysical activation using emotional speech or continuous visual recognition during PET scanning. In patients who had undergone total cerebral hemispherectomy because of uncontrolled epilepsy, remarkable recruitment of association areas was observed on both motor and speech activation.
采用2-[F-18]氟脱氧葡萄糖法，对124例各种类型癫痫患者进行了213次局部脑葡萄糖代谢（CMRglu）的正电子发射断层扫描（PET）研究。原发性癫痫患者的发作间期PET扫描通常显示出一些整体代谢抑制以及岛叶、基底和颞叶前部皮质功能活动降低。Kozevnikov连续性部分性癫痫的特征是中央前回皮质代谢减低或增高。结节性硬化症的特点是新皮质灶葡萄糖消耗显著减少。即使在发作间期静息状态下，就病灶定位的敏感性（大于90%）和准确性而言，PET在典型颞叶癫痫中优于其他诊断方法。大多数代谢减低灶平均比正常CMRglu低23%，位于颞叶内侧结构。通过在PET扫描期间使用情感言语或连续视觉识别进行心理物理激活，可更好地区分致痫区和显示相对正常功能反应性的周围组织。在因癫痫无法控制而接受全脑半球切除术的患者中，在运动和言语激活时均观察到联合区有明显的募集。
