Engel J, Kuhl D E, Phelps M E, Crandall P H
Ann Neurol. 1982 Dec;12(6):529-37. doi: 10.1002/ana.410120605.
One or more interictal positron computed tomograms of 18F-fluorodeoxyglucose were obtained on 50 patients with partial seizure disorders. Ictal as well as interictal electroencephalographic (EEG) data were available for all 50 patients, with scalp, sphenoidal, and depth electrode recordings done on 27 and scalp and sphenoidal recordings alone on 23. Thirty-five patients demonstrated one or more abnormal interictal zones of hypometabolism, while combined EEG studies were localizing for 36. There were considerable disagreements between the location of metabolic deficits and the epileptic focus revealed by individual scalp and depth EEG recorded ictal and interictal epileptiform activity; however, there was good correlation between the site of focal hypometabolism and the epileptic focus determined by the combined results of all electrophysiological studies. When focal hypometabolism and focal nonepileptiform EEG abnormalities (i.e., slow waves and attenuation of fast rhythms) were both present in the same patient, their localization agreed completely. Metabolic and combined electrophysiological techniques both occasionally produced false positive as well as false negative results. When used together, the EEG can confirm that a hypometabolic zone is epileptogenic, while FDG scans may indicate whether an epileptic EEG focus represents a lesion or propagation from a distant site.
对50例部分性癫痫患者进行了一次或多次18F-氟脱氧葡萄糖发作间期正电子计算机断层扫描。所有50例患者均有发作期及发作间期脑电图（EEG）数据，其中27例患者进行了头皮、蝶骨电极及深部电极记录，23例患者仅进行了头皮及蝶骨电极记录。35例患者显示一个或多个发作间期代谢减低异常区，而联合脑电图研究定位出36个异常区。代谢缺陷部位与通过个体头皮及深部脑电图记录的发作期及发作间期癫痫样活动所揭示的癫痫病灶之间存在相当大的差异；然而，局灶性代谢减低部位与所有电生理研究联合结果所确定的癫痫病灶之间存在良好的相关性。当同一患者同时存在局灶性代谢减低和局灶性非癫痫样脑电图异常（即慢波和快节律衰减）时，它们的定位完全一致。代谢和联合电生理技术偶尔都会产生假阳性和假阴性结果。联合使用时，脑电图可以确认代谢减低区是否为致痫区，而FDG扫描可能表明癫痫性脑电图病灶是代表一个病变还是远处部位的传播。
