Franceschi M, Lucignani G, Del Sole A, Grana C, Bressi S, Minicucci F, Messa C, Canevini M P, Fazio F
Department of Neurology, Scientific Institute H San Raffaele, Milan, Italy.
J Neurol Neurosurg Psychiatry. 1995 Oct;59(4):427-31. doi: 10.1136/jnnp.59.4.427.
Positron emission tomography with [18F]-2-fluoro-2-deoxy-D-glucose ([18F]FDG) has been used to assess the pattern of cerebral metabolism in different types of epilepsies. However, PET with [18F]FDG has never been used to evaluate drug naive patients with cryptogenic temporal lobe epilepsy, in whom the mechanism of origin and diffusion of the epileptic discharge may differ from that underlying other epilepsies. In a group of patients with cryptogenic temporal lobe epilepsy, never treated with antiepileptic drugs, evidence has been found of significant interictal glucose hypermetabolism in a bilateral neural network including the temporal lobes, thalami, basal ganglia, and cingular cortices. The metabolism in these areas and frontal lateral cortex enables the correct classification of all patients with temporal lobe epilepsy and controls by discriminant function analysis. Other cortical areas--namely, frontal basal and lateral, temporal mesial, and cerebellar cortices--had bilateral increases of glucose metabolism ranging from 10 to 15% of normal controls, although lacking stringent statistical significance. This metabolic pattern could represent a pathophysiological state of hyperactivity predisposing to epileptic discharge generation or diffusion, or else a network of inhibitory circuits activated to prevent the diffusion of the epileptic discharge.
正电子发射断层扫描术利用[18F]-2-氟-2-脱氧-D-葡萄糖（[18F]FDG）已被用于评估不同类型癫痫的脑代谢模式。然而，[18F]FDG正电子发射断层扫描术从未被用于评估未经治疗的隐源性颞叶癫痫患者，这类患者癫痫放电的起源和扩散机制可能与其他癫痫不同。在一组从未接受过抗癫痫药物治疗的隐源性颞叶癫痫患者中，已发现证据表明，在包括颞叶、丘脑、基底神经节和扣带回皮质的双侧神经网络中存在显著的发作间期葡萄糖代谢亢进。通过判别函数分析，这些区域以及额叶外侧皮质的代谢情况能够对所有颞叶癫痫患者和对照者进行正确分类。其他皮质区域，即额叶基底和外侧、颞叶内侧和小脑皮质，葡萄糖代谢有双侧增加，幅度为正常对照者的10%至15%，尽管缺乏严格的统计学意义。这种代谢模式可能代表一种易于癫痫放电产生或扩散的多动病理生理状态，或者是为防止癫痫放电扩散而激活的抑制性回路网络。
