Hajek M, Antonini A, Leenders K L, Wieser H G
Neurological Department, University Hospital Zürich, Switzerland.
Neurology. 1993 Jan;43(1):79-86. doi: 10.1212/wnl.43.1_part_1.79.
Metabolic abnormalities in the temporal lobe (TL) of 25 patients suffering from temporal lobe epilepsy of mesiobasal or lateral TL origin have been investigated using interictal [18F]-fluorodeoxyglucose (FDG) positron emission tomography (PET). The epileptogenic area was determined by ictal EEG recordings using foramen ovale and scalp electrodes in 20 patients, and by the use of stereo-electroencephalography in one patient. Four patients with structural lesions on their MRIs had noninvasive ictal surface EEG recordings. Sixteen patients had a clear-cut mesiobasal seizure onset, and in five patients the seizures originated from the lateral temporal neocortex. Twenty-four patients underwent selective surgery. Patients with temporal limbic seizures associated with mesial gliosis (n = 15) had the lowest FDG uptake in the entire TL, followed by patients with lateral temporal seizure origin (n = 5). Patients with tumors located in the mesiobasal TL (n = 5) showed, in general, only a slight decrease of glucose metabolism in all TL structures. There was no clear-cut correlation between the degree of hypometabolism and the location of EEG-defined epileptogenic focus. The metabolic pattern, however, differed between the patient groups and allowed a discrimination between patients of mesial temporal and lateral temporal seizure onset.
利用发作间期[18F] - 氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）对25例起源于中基底或外侧颞叶的颞叶癫痫患者的颞叶代谢异常进行了研究。20例患者通过卵圆孔和头皮电极进行发作期脑电图记录来确定致痫区，1例患者使用立体脑电图来确定致痫区。4例MRI有结构性病变的患者进行了非侵入性发作期表面脑电图记录。16例患者有明确的中基底发作起始，5例患者的发作起源于外侧颞叶新皮质。24例患者接受了选择性手术。伴有内侧胶质增生的颞叶边缘性发作患者（n = 15）在整个颞叶中的FDG摄取最低，其次是发作起源于外侧颞叶的患者（n = 5）。位于中基底颞叶的肿瘤患者（n = 5）总体上在所有颞叶结构中仅显示葡萄糖代谢略有下降。代谢减低程度与脑电图定义的致痫灶位置之间没有明确的相关性。然而，不同患者组之间的代谢模式不同，能够区分内侧颞叶发作和外侧颞叶发作的患者。
