van Bogaert P, Chiron C, Adamsbaum C, Robain O, Diebler C, Dulac O
Department of Pediatric Neurology, Hôpital Saint-Vincent-De-Paul, Paris, France.
Epilepsia. 1993 Jul-Aug;34(4):701-6. doi: 10.1111/j.1528-1157.1993.tb00449.x.
Magnetic resonance imaging (MRI) studies of 46 patients with West syndrome (WS) of unknown etiology were reviewed retrospectively. The criteria for cryptogenic WS were met by 25 and 21 were considered symptomatic because other types of seizure or psychomotor retardation were apparent before spasm onset. Computed tomographic (CT) scans were normal in 38 patients and showed diffuse atrophy in eight symptomatic patients. In five patients, MRI was more informative than CT, demonstrating one case of delayed myelination and four cases of focal lesion. The focal lesion in 2 of these patients was similar on MRI consisting of poor gray-white matter demarcation in the parieto-occipitotemporal region. Surgical resection was performed in one because of intractable seizures, and neuropathological examination revealed cortical dysplasia. The remaining two cases with focal lesion had increased signal intensity on T2-weighted images in the posterior frontal cortex and in the temporal lobe, respectively. Our data indicate that MRI is useful in some cases of WS, especially in demonstrating focal corticosubcortical lesions not visible on CT scan.
对46例病因不明的韦斯特综合征（WS）患者的磁共振成像（MRI）研究进行了回顾性分析。25例符合隐源性WS的标准，21例因在痉挛发作前出现其他类型的癫痫发作或精神运动发育迟缓而被认为是症状性的。38例患者的计算机断层扫描（CT）正常，8例症状性患者显示弥漫性萎缩。5例患者中，MRI比CT提供了更多信息，其中1例显示髓鞘延迟形成，4例显示局灶性病变。其中2例患者的局灶性病变在MRI上相似，表现为顶枕颞叶区域灰白质分界不清。1例因顽固性癫痫发作接受了手术切除，神经病理学检查显示皮质发育异常。其余2例局灶性病变患者分别在额叶后部皮质和颞叶的T2加权图像上信号强度增加。我们的数据表明，MRI在某些WS病例中有用，特别是在显示CT扫描上不可见的局灶性皮质下皮质病变方面。
