Otsubo H, Hwang P A, Jay V, Becker L E, Hoffman H J, Gilday D, Blaser S
Division of Neurology, Hospital for Sick Children, University of Toronto, Ontario, Canada.
Pediatr Neurol. 1993 Mar-Apr;9(2):101-7. doi: 10.1016/0887-8994(93)90043-c.
A retrospective analysis was conducted of 9 children with focal cortical dysplasia and localization-related epilepsy who underwent epilepsy surgery. Focal cortical dysplasia includes malformed lesions with extensive abnormalities of neuronal morphology, architecture, and lamination. The patients were examined by EEG and video EEG telemetry, CT, MRI, and SPECT using 99mTc-HmPAO. EEG disclosed interictal localized epileptiform activity in 8 patients and nonepileptiform activity with slow waves in 1. Ictal EEG telemetry demonstrated a predominantly localized seizure onset in 8 patients and MRI demonstrated an abnormal loss of gray and white matter distinction in 6. Decreased regional cerebral blood flow (rCBF) was detected in 4 patients by interictal SPECT, and increased rCBF in the same epileptogenic focus in 2 by postictal SPECT. Pathologic analysis found focal cortical dysplasia in 8 patients. One had extensive focal polymicrogyria, pachygyria, and extensive white matter heterotopias. It is concluded that MRI can detect focal cortical dysplasia, which corresponds to the epileptogenic focus on EEG, and SPECT may help to detect a functional abnormality in the same region.
对9例患有局灶性皮质发育不良并伴有定位相关癫痫的儿童进行了回顾性分析，这些儿童均接受了癫痫手术。局灶性皮质发育不良包括具有神经元形态、结构和分层广泛异常的畸形病变。对患者进行了脑电图（EEG）和视频脑电图遥测、CT、MRI以及使用99mTc-HmPAO的单光子发射计算机断层扫描（SPECT）检查。脑电图显示8例患者发作间期有局灶性癫痫样活动，1例有非癫痫样慢波活动。发作期脑电图遥测显示8例患者发作起始主要为局灶性，MRI显示6例患者灰质和白质分界异常。发作间期SPECT检测到4例患者局部脑血流（rCBF）降低，发作后期SPECT检测到2例患者同一致痫灶rCBF增加。病理分析发现8例患者存在局灶性皮质发育不良。1例有广泛的局灶性多小脑回、巨脑回以及广泛的白质异位。结论是MRI可检测到局灶性皮质发育不良，其与脑电图上的致痫灶相对应，SPECT可能有助于检测同一区域的功能异常。
