Sackellares J C, Siegel G J, Abou-Khalil B W, Hood T W, Gilman S, McKeever P E, Hichwa R D, Hutchins G D
Department of Neurology, University of Michigan School of Medicine, Ann Arbor 48109-0316.
Neurology. 1990 Sep;40(9):1420-6. doi: 10.1212/wnl.40.9.1420.
We performed interictal [18F]-2-fluoro-2-deoxy-D-glucose positron emission tomography in 17 patients with well-defined unilateral anterior mesial temporal epileptogenic foci as determined by EEG procedures. Sixteen of these patients subsequently underwent surgical resection of the epileptogenic focus. We measured local cerebral metabolic rates for glucose in mesial and lateral temporal structures and compared them with metabolic rates for analogous regions in 16 healthy normal volunteers and the contralateral hemisphere of the epileptic patients. We found relative hypometabolism ipsilateral to the seizure focus more frequently and to a greater degree in the lateral than in the mesial temporal cortex. Since the physiologic abnormalities involved mesial temporal structures, this observation suggests that functional pathways exist between mesial and lateral temporal cortex normally and that these pathways are altered in epilepsy of mesial temporal origin. Hypometabolism did not correlate well with histologic abnormalities in the surgical specimens.
我们对17例经脑电图检查确定有明确单侧前内侧颞叶癫痫病灶的患者进行了发作间期[18F]-2-氟-2-脱氧-D-葡萄糖正电子发射断层扫描。其中16例患者随后接受了癫痫病灶的手术切除。我们测量了内侧和外侧颞叶结构的局部脑葡萄糖代谢率，并将其与16名健康正常志愿者以及癫痫患者对侧半球类似区域的代谢率进行比较。我们发现，与发作灶同侧的外侧颞叶皮质比内侧颞叶皮质更频繁、程度更高地出现相对代谢减低。由于生理异常涉及内侧颞叶结构，这一观察结果表明，内侧和外侧颞叶皮质之间通常存在功能通路，且这些通路在起源于内侧颞叶的癫痫中发生了改变。代谢减低与手术标本中的组织学异常相关性不佳。
