Miyazaki M, Hashimoto T, Omura H, Fujii E, Tayama M, Kuroda Y
Department of Pediatrics, Tokushima University School of Medicine.
No To Hattatsu. 1994 May;26(3):251-6.
We experienced a 6-month-old girl with infantile spasms who had localized cerebral lesion detected by 99mTcHMPAO-SPECT. She was born vaginally after a full term uncomplicated delivery with a birth weight of 3,100 g. She developed emprosthotonic spasms with series formation and EEG showed asymmetric periodic hypsarrhythmia which was predominant in the right hemisphere. While MRI could not detected any focal lesion, 99mTcHMPAO-SPECT disclosed hypoperfusion at the right anterior temporal and frontal areas. Although vitamin B6, clonazepam and sodium valproate were administered with no remarkable benefit, the treatment with ACTH-Z or carbamazepine resulted in cessation of spasms and improvement of the EEG findings. Consequently, the study with 99mTcHMPAO-SPECT was useful to clarify the pathology of infantile spasms, and we concluded that a patient with localized cerebral lesions should be given carbamazepine.
我们接诊了一名患有婴儿痉挛症的6个月大女孩，通过99mTcHMPAO单光子发射计算机断层扫描（SPECT）检测到其脑部有局限性病变。她足月顺产，出生体重3100克，经阴道分娩，过程顺利。她出现了前弓反张痉挛并呈串出现，脑电图显示不对称性周期性高度节律失调，以右半球为主。虽然磁共振成像（MRI）未检测到任何局灶性病变，但99mTcHMPAO-SPECT显示右前颞叶和额叶区域灌注不足。尽管给予了维生素B6、氯硝西泮和丙戊酸钠治疗，效果并不显著，但使用促肾上腺皮质激素（ACTH-Z）或卡马西平治疗后，痉挛停止，脑电图结果有所改善。因此，99mTcHMPAO-SPECT研究有助于明确婴儿痉挛症的病理，我们得出结论，对于有局限性脑病变的患者应给予卡马西平治疗。
