Martínez M, Santamaría J, Mercader J M, Catafau A, Cardenal C, Lomeña F
Epilepsy Unit (Neurology Service), Hospital Clinic, Barcelona, Spain.
Neuroradiology. 1994;36(1):11-6. doi: 10.1007/BF00599185.
The effectiveness of surgery in patients with refractory complex partial seizures depends on accurate localisation of the epileptogenic zone. To assess the correlation between magnetic resonance imaging (MRI) hippocampal volume measurements. Tc 99m-hexamethyl-propyleneamineoxime inter- and postictal single photon emission computed tomography (SPECT) and clinico-electrophysiological (video/EEG) localisation of the epileptogenic zone we prospectively studied 16 consecutive patients with refractory complex partial seizures and no significant abnormality on standard MRI. Each test was interpreted blindly by independent observers. Eight patients (50%) had asymmetrical hippocampal volumes indicative of unilateral atrophy; correlation with the video/EEG and postical SPECT changes was very high (100% with definitive video/EEG localisation, 75% with interictal EEG and 83% with postictal SPECT). Moreover, the left/right hippocampal ratio was able to differentiate temporal from extratemporal video/EEG localisations. Postictal SPECT showed regional lateralised changes in 9 (64%) of 14 technically satisfactory studies. Disagreement between the video/EEG and postictal SPECT was seen with two extratemporal and one bitemporal foci.
手术治疗难治性复杂部分性癫痫患者的疗效取决于癫痫病灶区的准确定位。为了评估磁共振成像（MRI）海马体积测量、锝99m - 六甲基丙烯胺肟发作间期和发作期单光子发射计算机断层扫描（SPECT）与癫痫病灶区临床电生理（视频/脑电图）定位之间的相关性，我们对16例连续的难治性复杂部分性癫痫患者进行了前瞻性研究，这些患者在标准MRI上无明显异常。每项检查均由独立观察者进行盲法解读。8例患者（50%）海马体积不对称，提示单侧萎缩；与视频/脑电图及发作期SPECT变化的相关性非常高（明确的视频/脑电图定位相关性为100%，发作间期脑电图为75%，发作期SPECT为83%）。此外，左右海马比例能够区分颞叶和颞外视频/脑电图定位。在14项技术上满意的研究中，9例（64%）发作期SPECT显示出局部侧化改变。在两个颞外病灶和一个双侧颞叶病灶中，视频/脑电图与发作期SPECT存在分歧。
