Epilepsy Center, Department of Neurology, University of Munich, Munich, Germany.
Epileptic Disord. 2018 Oct 1;20(5):447-450. doi: 10.1684/epd.2018.0991.
We report a patient with frontal lobe epilepsy due to a right frontal astrocytoma (WHO Grade III) in whom two ictal SPECTs (single photon emission tomography) were performed during two seizures with different semiology and different EEG seizure patterns. Subtraction of ictal and interictal SPECT showed right lateral frontal hyperperfusion during a left face clonic seizure, and right mesial fronto-polar hyperperfusion during a subclinical seizure. This report demonstrates that ictal SPECT may reflect different seizure semiology from the frontal lobe of the same individual and that simultaneous EEG is indispensable for the correct interpretation of SPECT in epilepsy.
我们报告了一例因右侧额叶星形细胞瘤（WHO 分级 III）导致额叶癫痫的患者，该患者在两次具有不同临床表现和不同 EEG 痫性发作模式的癫痫发作期间进行了两次发作期 SPECT（单光子发射计算机断层扫描）。发作期和发作间期 SPECT 减影显示左颜面阵挛性发作时右侧外侧额叶高灌注，亚临床发作时右侧额极内侧高灌注。本报告表明，发作期 SPECT 可能反映同一个体额叶不同的癫痫发作临床表现，而同步 EEG 对于正确解读癫痫发作期 SPECT 是不可或缺的。
