Arocha Pérez Jorge L, Morales Chacón Lilia M, Batista García Ramo Karla, Galán García Lídice
International Center for Neurological Restoration, 25th Ave, No 15805, Playa, Havana 11300, Cuba.
Cuban Neurosciences Center, 25th Ave, No 15202, Playa, Havana 11300, Cuba.
Behav Sci (Basel). 2022 Apr 14;12(4):107. doi: 10.3390/bs12040107.
Ictal semiology and brain single-photon emission computed tomography have been performed in approaching the epileptogenic zone in drug-resistant focal epilepsies. The authors aim to describe the brain structures involved in the ictal and interictal epileptogenic network from sequential semiology and brain perfusion quantitative patterns analysis. A sequential representation of seizures was performed (n = 15). A two-level analysis (individual and global) was carried out for the analysis of brain perfusion quantification and estimating network structures from the perfusion indexes. Most of the subjects started with focal seizures without impaired consciousness, followed by staring, automatisms, language impairments and evolution to a bilateral tonic-clonic seizure (temporal lobe and posterior quadrant epilepsy). Frontal lobe epilepsy seizures continued with upper limb clonus and evolution to bilateral tonic-clonic. The perfusion index of the epileptogenic zone ranged between 0.439-1.362 (mesial and lateral structures), 0.826-1.266 in dorsolateral frontal structures and 0.678-1.507 in the occipital gyrus. The interictal epileptogenic network proposed involved the brainstem and other subcortical structures. For the ictal state, it included the rectus gyrus, putamen and cuneus. The proposed methodology provides information about the brain structures in the neural networks in patients with drug-resistant focal epilepsies.
在难治性局灶性癫痫中，已采用发作期症状学和脑单光子发射计算机断层扫描来接近致痫区。作者旨在通过连续的症状学和脑灌注定量模式分析，描述发作期和发作间期致痫网络中涉及的脑结构。对发作进行了连续记录（n = 15）。对脑灌注定量分析以及根据灌注指数估计网络结构进行了两级分析（个体和整体）。大多数受试者起始为局灶性发作且意识未受损，随后出现凝视、自动症、语言障碍，并演变为双侧强直阵挛发作（颞叶和后象限癫痫）。额叶癫痫发作持续出现上肢阵挛并演变为双侧强直阵挛。致痫区的灌注指数范围在0.439 - 1.362之间（内侧和外侧结构），背外侧额叶结构为0.826 - 1.266，枕叶为0.678 - 1.507。所提出的发作间期致痫网络涉及脑干和其他皮质下结构。对于发作期状态，它包括直回、壳核和楔叶。所提出的方法提供了有关难治性局灶性癫痫患者神经网络中脑结构的信息。
