Theodore W H, Fishbein D, Dietz M, Baldwin P
Epilepsia. 1987 Jul-Aug;28(4):319-23. doi: 10.1111/j.1528-1157.1987.tb03650.x.
We used positron emission tomography (PET) with [18F]2-deoxyglucose to study cerebellar glucose metabolism (LCMRglu) and the effect of phenytoin (PHT) in 42 patients with complex partial seizures (CPS), and 12 normal controls. Mean +/- SD patient LCMRglu was 6.9 +/- 1.8 mg glucose/100 g/min (left = right), significantly lower than control values of 8.5 +/- 1.8 (left, p less than 0.006), and 8.3 +/- 1.6 (right, p less than 0.02). Only four patients had cerebellar atrophy on CT/MRI; cerebellar LCMRglu in these was 5.5 +/- 1.5 (p = 0.054 vs. total patient sample). Patients with unilateral temporal hypometabolism or EEG foci did not have lateralized cerebellar hypometabolism. Patients receiving phenytoin (PHT) at the time of scan and patients with less than 5 years total PHT exposure had lower LCMRglu, but the differences were not significant. There were weak inverse correlations between PHT level and cerebellar LCMRglu in patients receiving PHT (r = -0.36; 0.05 less than p less than 0.1), as well as between length of illness and LCMRglu (r = -0.22; 0.05 less than p less than 0.1). Patients with complex partial seizures have cerebellar hypometabolism that is bilateral and due only in part to the effect of PHT.
我们使用正电子发射断层扫描（PET）及[18F]2-脱氧葡萄糖来研究42例复杂部分性发作（CPS）患者和12名正常对照者的小脑葡萄糖代谢（局部脑葡萄糖代谢率，LCMRglu）以及苯妥英（PHT）的影响。患者的平均LCMRglu±标准差为6.9±1.8mg葡萄糖/100g/分钟（左侧=右侧），显著低于对照组值8.5±1.8（左侧，p<0.006）和8.3±1.6（右侧，p<0.02）。仅4例患者在CT/MRI上有小脑萎缩；这些患者的小脑LCMRglu为5.5±1.5（与患者总样本相比，p=0.054）。单侧颞叶代谢减低或脑电图病灶的患者没有小脑侧化代谢减低。扫描时接受苯妥英（PHT）治疗的患者以及PHT总暴露时间少于5年的患者LCMRglu较低，但差异不显著。接受PHT治疗的患者中，PHT水平与小脑LCMRglu之间存在弱负相关（r=-0.36；0.05<p<0.1），病程与LCMRglu之间也存在弱负相关（r=-0.22；0.05<p<0.1）。复杂部分性发作患者存在双侧小脑代谢减低，且仅部分归因于PHT的作用。
