Jibiki I, Kido H, Matsuda H, Yamaguchi N, Hisada K
Department of Neuropsychiatry, Kanazawa University School of Medicine, Japan.
Acta Neurol (Napoli). 1993 Feb;15(1):16-24.
Quantitative assessment of regional cerebral blood flow (rCBF) in the bilateral cerebral and cerebellar cortices was performed in 13 epileptic patients receiving long-term high-dose phenytoin (PHT) therapy, using single photon emission computed tomography (SPECT) with N-isopropyl-(iodine 123) p-iodoamphetamine. In 4 of the 13 patients, both the cerebellar to frontal rCBF ratio and cerebellar to cerebral rCBF ratio showed low values as compared with those in 22 normal subjects matched for sex and age, probably reflecting abnormal relative cerebellar hypoperfusion. None of the 4 patients showed any abnormal findings on X-ray computed tomography or magnetic resonance brain imaging. The patients with a history of acute PHT intoxication tended to show the abnormal relative cerebellar hypoperfusion. These results suggest the utility of SPECT scans for early detection of cerebellar abnormalities known to be often present in epileptic patients, and imply a risk of long-term high-dose PHT therapy.
采用单光子发射计算机断层扫描（SPECT）和N-异丙基-（碘123）对碘安非他明，对13例接受长期大剂量苯妥英（PHT）治疗的癫痫患者双侧大脑皮质和小脑皮质的局部脑血流量（rCBF）进行了定量评估。在这13例患者中，有4例患者的小脑与额叶rCBF比值以及小脑与大脑rCBF比值与22名年龄和性别匹配的正常受试者相比均较低，这可能反映了小脑相对灌注不足。这4例患者在X线计算机断层扫描或磁共振脑成像上均未显示任何异常发现。有急性PHT中毒史的患者往往表现出小脑相对灌注异常。这些结果表明SPECT扫描有助于早期发现癫痫患者中常见的小脑异常，并提示长期大剂量PHT治疗存在风险。
