Baldy-Moulinier M, Valmier J, Touchon J, Billiard M, Besset A, Cadilhac J
Rev Neurol (Paris). 1985;141(1):18-27.
Hemisphere and regional cerebral blood flow (CBF) were determined during interictal periods by intravenous Xenon 133 in 43 patients considered to have "temporal" epilepsy and presenting complex partial attacks with altered consciousness and lateralized EEG anomalies predominant in the temporal region. Brain scans were normal in all cases. Three subgroups were differentiated according to EEG and polygraphic examinations during sleep; temporal epilepsy with left or right EEG anomalies, with asynchronous bilateral EEG anomalies, with alternating labile unilateral EEG anomalies. Measurements of CBF were compared with those of normal subjects (n = 13) of comparable age and with those of epileptic patients with cerebral lesions on CT scan (n = 4). In epileptics with left EEG anomalies CBF was diminished by about 25 p. 100 in the left temporal region and from 15 to 22 p. 100 in other regions of the ipsi- and contralateral hemisphere. In epileptics with right EEG anomalies CBF was diminished by 20 p. 100 in the right temporal region but not on the left. CBF in the third group was comparable to that of normal subjects. In epileptics with abnormal CT scans the reduction in CBF could be correlated with EEG and CT scan findings. Studies were also conducted to determine variations in reactivity to CO2 in the areas with reduced flow, during ictal and interictal periods. Results emphasize the value of CBF measurements for investigation of epileptic foci. The importance of areas of reduced blood flow as a parameter of severity and course is discussed, as well as their pathophysiological significance.
在发作间期，通过静脉注射氙133，对43例被认为患有“颞叶”癫痫且表现为意识改变的复杂部分性发作以及颞叶区域为主的脑电图异常的患者进行了半球和区域脑血流量（CBF）测定。所有病例脑部扫描均正常。根据睡眠期间的脑电图和多导记录检查将患者分为三个亚组：脑电图异常位于左侧或右侧的颞叶癫痫、双侧脑电图异常不同步、单侧脑电图异常交替不稳定。将CBF测量值与年龄相当的正常受试者（n = 13）以及CT扫描有脑病变的癫痫患者（n = 4）的测量值进行比较。脑电图异常位于左侧的癫痫患者，左侧颞叶区域的CBF减少约25%，同侧和对侧半球其他区域减少15%至22%。脑电图异常位于右侧的癫痫患者，右侧颞叶区域的CBF减少20%，左侧则未减少。第三组的CBF与正常受试者相当。CT扫描异常的癫痫患者，CBF的降低可与脑电图和CT扫描结果相关。还进行了研究以确定发作期和发作间期血流减少区域对二氧化碳反应性的变化。结果强调了CBF测量在癫痫病灶研究中的价值。讨论了血流减少区域作为严重程度和病程参数的重要性及其病理生理意义。
