长期应用抗癫癎药控制的颞叶癫癎患者发作间期SPECT异常灌注灶修复与长程视频脑电图变化的临床研究  

Clinical Study of Repair of Interictcal SPECT Abnormal Perfusion Foci and V-EEG of Temporal Lobe Epilepsy with Patients in Long-term Control with Antiepilepsy Drugs

作　　者：王为民[1] 柳江燕[1] 赵斯钰[1] 刘亚青[1] 

机构地区：[1]兰州大学第二医院神经内科癫癎中心甘肃省癫癎防治中心,730030

出　　处：《中国临床神经科学》2010年第5期520-525,共6页Chinese Journal of Clinical Neurosciences

基　　金：甘肃省攻关课题项目(编号:432328)

摘　　要：目的:探讨抗癫癎药(AEDs)长期控制的颞叶癫癎患者发作期间应用单光子发射电子计算机断层扫描(SPECT)检查异常灌注灶的修复。方法:颞叶癫癎患者经AEDs、步长脑心通胶囊与尼莫地平治疗,并在两次发作间期行SPECT、长程视频脑电图(V-EEG)和CT/MRI检查。结果:44例癫癎患者平均年龄为25岁;平均病程为3.5年;44例患者中病因明确者为19例(家族史2例,围产期损伤1例,热性惊厥3例,颅脑损伤出血1例,颅脑外伤5例,脑膜脑炎3例,脑部手术2例,多病因2例)。癫癎发作控制平均为25个月。治疗前发作间期SPECT异常(颞叶和非颞叶)感兴趣区(ROI)为77.3%,长程V-EEG异常77.3%(其中癎样放电88.2%),治疗前CT/MRI异常47.7%。治疗后发作间期SPECT正常增加4.5%(P>0.05),异常灶减少8.3%(P>0.05);长程V-EEG正常增加27.3%(P<0.05),癎样放电减少53.3%(P<0.05);结论:长期控制的颞叶癫癎患者的异常灌注灶修复明显低于其他类型癫癎,防治重点应放在颞叶癫癎症状出现之前的继发性全身强直阵挛发作。Aim：To discuss the result of repair of abnormal perfusion foci of patients with temporal lobe epilepsy in long-term controled with antiepilepsy drugs（AEDs） by single photon emission computed tomography （SPECT） interictcally.Methods：The 44 cases with the AEDs,Chinese medicine＂Nao xin tong＂and NMD treated and twice with interictcal SPECT,long-term EEG and CT/MRI were performed.Results：The average time of whole ictcal control was 25 months.The average age of the patients was 25.The average course was 3.5 years.The cases of etiology dear-cut were 19（household history 2 cases,perinatal stage injure 1 case,febrile convulsion 3 cases,braiin injure bleeding 1 case,brain trauma 5 cases,encephalitis 3 cases,brain operation 2 cases,many etiology 2 cases）.Before treatment the ROI of interictcal SPECT abnormal（terporal and non terporal region） was 77.3%,V-EEG abnormal was 77.3%（among epileptic discharges was 88.2%,and CT/MRI abnormal was 47.7%.After treatment interictcal SPECT normal increased 4.54%（P0.05） and abnormal perfusion foci decreased 8.33%（F0.05）.V-EEG normal increased 27.3%（P0.05） and epileptic discharges decreased 53.3%（P0.05）.Conclusion：The repair of abnormal perfusion foci of temporal lobe epilepsy in long-term controled with drugs was obviously lower than other epilepsy type.Its prevention and curation should be emphasized on tonic-clonic seizure before temporal lobe epilepsy.

关 键 词：颞叶癫癎 抗癫癎药 单光子发射电子计算机断层扫描 

分 类 号：R742.1[医药卫生—神经病学与精神病学]