Theodore W H, Newmark M E, Sato S, Brooks R, Patronas N, De La Paz R, DiChiro G, Kessler R M, Margolin R, Manning R G
Ann Neurol. 1983 Oct;14(4):429-37. doi: 10.1002/ana.410140406.
Positron emission tomography with simultaneous electroencephalographic monitoring was performed with [18F]fluorodeoxyglucose in 20 patients with complex partial seizures who had normal computed tomographic scans. Seven patients had only unilateral epileptiform discharges on the electroencephalogram, 3 had predominantly unilateral discharges, and 10 had nonlocalized epileptiform abnormalities. Positron emission tomography showed a hypometabolic lesion in 16 of the 20 patients. Pathological changes in the hypometabolic region were found in postoperative specimens in 4 of 5 patients studied. Positron emission tomography was unaffected by the seizure frequency, state of alertness, or number of spike discharges during the scan. There was a tendency for patients to have higher overall metabolic rates when taking less medication. Seizures occurring during [18F]fluorodeoxyglucose uptake in 3 patients produced a hypermetabolic area at the interictal hypometabolic focus. Positron emission tomography sometimes showed more widespread hypometabolism than suspected on the basis of the scalp-recorded electroencephalogram. The frontal lobe showed a greater degree of hypometabolism than the temporal lobe in 3 patients. Focal lesions may be identified by positron emission tomography even if the electroencephalographic abnormality is not well localized.
对20例计算机断层扫描正常的复杂部分性癫痫患者，采用[18F]氟脱氧葡萄糖进行正电子发射断层扫描并同步进行脑电图监测。7例患者脑电图仅有单侧癫痫样放电，3例主要为单侧放电，10例有非局限性癫痫样异常。正电子发射断层扫描显示20例患者中有16例存在代谢减低病灶。在接受研究的5例患者中，有4例术后标本在代谢减低区域发现了病理改变。正电子发射断层扫描不受扫描期间癫痫发作频率、警觉状态或棘波放电数量的影响。服用较少药物的患者往往有较高的整体代谢率。3例患者在[18F]氟脱氧葡萄糖摄取期间发生的癫痫发作在发作间期代谢减低灶处产生了一个代谢增高区域。正电子发射断层扫描有时显示出比头皮记录脑电图所怀疑的更广泛的代谢减低。3例患者额叶的代谢减低程度比颞叶更大。即使脑电图异常定位不明确，正电子发射断层扫描也可能识别出局灶性病变。
