Theodore W H, Fishbein D, Dubinsky R
Medical Neurology Branch, National Insitute of Neurological and Communicative Disorders and Stroke, Bethesda, MD 20892.
Neurology. 1988 Aug;38(8):1201-6. doi: 10.1212/wnl.38.8.1201.
We analyzed local cerebral metabolic rates of glucose (LCMRglu) in 20 regions from 22 patients with complex partial seizures, who were taking neither phenytoin nor phenobarbital and who had normal CTs. Results were compared with data from 19 normal controls. Ten patients had left temporal, eight right temporal, and four bitemporal or generalized EEG discharges. There were no significant differences between patient and control values in any of 20 regions of interest. LCMRglu was depressed at the site of the epileptic focus: L/R ratio was 0.85 +/- 0.12 (p less than 0.003 compared with control), 0.92 +/- 0.08 (p less than 0.05), and 0.84 +/- 0.1 (p less than 0.001), respectively, in mesial, superior, and inferior temporal regions for patients with left temporal foci; 1.7 +/- 0.96 (p less than 0.04), 1.1 +/- 0.1 (NS), and 1.15 +/- 0.04 (p less than 0.001) for patients with right temporal foci. Patients with left temporal EEG foci had significantly lower values than patients with right temporal foci in left superior frontal and thalamic as well as left temporal regions, while patients with right-sided EEG foci had depressed LCMRglu (compared with patients with left temporal EEG foci) restricted to right mesial temporal lobe. The patients with left temporal foci tended to have longer seizure histories (22.7 +/- 5.4 versus 11 +/- 5.6 years; p less than 0.001). There was an inverse correlation between length of seizure history and mean LCMRglu (r = 0.38; 0.1 greater than p greater than 0.05). Our study suggests that LCMRglu is not depressed in regions beyond the epileptic focus when patients are not taking drugs known to decrease cerebral glucose metabolism.
我们分析了22例复杂部分性癫痫患者20个区域的局部脑葡萄糖代谢率（LCMRglu），这些患者既未服用苯妥英也未服用苯巴比妥，且CT检查正常。将结果与19名正常对照者的数据进行比较。10例患者脑电图放电位于左侧颞叶，8例位于右侧颞叶，4例为双侧颞叶或全身性放电。在20个感兴趣区域中的任何一个区域，患者和对照者的值均无显著差异。癫痫灶部位的LCMRglu降低：左侧颞叶病灶患者的内侧、上侧和下侧颞叶区域的左右比值分别为0.85±0.12（与对照相比，p<0.003）、0.92±0.08（p<0.05）和0.84±0.1（p<0.001）；右侧颞叶病灶患者分别为1.7±0.96（p<0.04）、1.1±0.1（无显著性差异）和1.15±0.04（p<0.001）。左侧颞叶脑电图病灶患者在左侧额上回、丘脑以及左侧颞叶区域的值显著低于右侧颞叶病灶患者，而右侧脑电图病灶患者的LCMRglu降低（与左侧颞叶脑电图病灶患者相比）仅限于右侧内侧颞叶。左侧颞叶病灶患者的癫痫病史往往更长（22.7±5.4年对11±5.6年；p<0.001）。癫痫病史长度与平均LCMRglu之间存在负相关（r=0.38；0.1>p>0.05）。我们的研究表明，当患者未服用已知会降低脑葡萄糖代谢的药物时，癫痫灶以外区域的LCMRglu不会降低。
