Sözüer D T, Onsel C, Altiok E, Uslu I, Yalçin E
Department of Pediatric Neurology, Cerrahpaşa Medical Faculty, University of Istanbul, Turkey.
Brain Dev. 1996 Mar-Apr;18(2):95-8. doi: 10.1016/0387-7604(95)00134-4.
Cerebellar and cerebral subcortical blood flow in 41 children with partial epilepsy and 6 normal controls was investigated during the interictal state using single photon emission computed tomography with technetium-99m hexamethylpropyleneamineoxime. Seventeen of 41 patients had been treated with antiepileptic drugs (AEDs) for 4.65 +/- 3.80 years (range 0.2-12) and 24 patients were drug-free. Unilateral hypoperfusion of cerebellum and cerebral subcortical gray matter was demonstrated in 11 (28%) and 16 (40%) patients, respectively. Most of them also had focal cerebral cortical perfusion abnormalities, ipsilateral or contralateral to the cerebellar and cerebral subcortical hypoperfusion. The mean asymmetry indices of cerebellar blood flow in the medicated and the unmedicated patients were significantly higher than in the control cases (P < 0.02 and P < 0.04), whereas the differences in the asymmetry indices in cerebral subcortical areas were insignificant. AED therapy did not affect the perfusion of cerebellum and cerebral subcortical regions (P > 0.05 and P > 0.05). Our results suggest that functional alterations on anatomically connected remote areas in patients with partial epilepsy are not related to the drug effect and probably due to primary epileptogenic activity.
利用锝-99m六甲基丙烯胺肟单光子发射计算机断层扫描技术，对41例部分性癫痫患儿和6名正常对照者在发作间期的小脑和大脑皮质下血流情况进行了研究。41例患者中，17例接受抗癫痫药物（AEDs）治疗4.65±3.80年（范围0.2 - 12年），24例未用药。分别有11例（28%）和16例（40%）患者出现小脑和大脑皮质下灰质单侧灌注不足。他们中的大多数还存在局灶性大脑皮质灌注异常，与小脑和大脑皮质下灌注不足同侧或对侧。用药患者和未用药患者小脑血流的平均不对称指数均显著高于对照病例（P < 0.02和P < 0.04），而大脑皮质下区域不对称指数的差异不显著。AED治疗不影响小脑和大脑皮质下区域的灌注（P > 0.05和P > 0.05）。我们的结果表明，部分性癫痫患者解剖学上相连的远隔区域的功能改变与药物作用无关，可能是由于原发性致痫活动所致。
