影像学正常的癫痫患者的SPECT与长程EEG研究  

Interictal SPECT and long-term V-EEG of epileptics with normal imaging

作　　者：王为民[1] 王天成[1] 叶江[1] 赵莉[1] 韩红梅[1] 王文婷[1] 赵斯钰[1] 刘亚青[1] 

机构地区：[1]兰州大学第二医院癫痫中心 甘肃省癫痫防治中心,甘肃兰州730030

出　　处：《癫痫与神经电生理学杂志》2010年第6期324-327,共4页Journal of Epileptology and Electroneurophysiology(China)

基　　金：基金项目：甘肃省攻关课题（项目代码：432328）

摘　　要：目的：探讨影像学（CT和MRI）正常的癫痫病例的发作间期SPECT与脑电图（EEG）特点。方法：对100例影像学正常病例在发作间期进行SPECT显像、EEG长程监测。结果：共100例中，男57例，女43例。年龄1～54岁。病程平均3．77年。可追溯到病因者63％。全身性发作58％（全身强直阵挛发作52％），局灶性发作42％。发作间期SPECT异常100％，其中低灌注67％，高灌注30％，高一低灌注3％。异常灌注灶156个：脑区151个（97％），其中颞叶76例94个（60％）。长程EEG监测正常17％，异常83％，异常者中90％有痫样放电。局灶性异常45％和弥漫性异常54％，EEG正常的全身性发作与局灶性发作差异明显（P〈0．01）；局灶性异常中全身性发作与局灶性发作比较差异有统计学意义（P〈0．05）。结论：影像学正常而发作间期SPECT异常的癫痫病例和EEG异常明显增高，全身性发作者各脑区均存在异常灌注灶，其中颞叶异常灌注灶占60．2％。Objective：To explore the characteristics of SPECT and long-term V-EEG of epileptic patients in normal CT/MRI imaging. Methods： All cases were examined with interictal SPECT and longterm monitoring EEG. Results：One hundred patients were performed（57 men and 43 women,age range： 1-54 years, the average course.. 3. 77 years and cause-awared： 63 %. generalized epilepsy： 58 % including generalized tonic clonic seizure 52% and partial epilepsy 42%. Interictal SPECT is abnormal 100%：hypoperfusion 67 %, hypertransfusion 30% , hyper-hypo perfusion 30%. There were 156 focus of abnormal perfusion：151 focus on cortex（96.7%）,temporal lobe was 76 cases（94 focus,60.2 %）. EEG long-term monitoring normal 17 %, abnormal 83 % （including epileptic discharge 90% ; focal abnormality 45 % and diffuse abnormality 54%）. Conclusion： Interictal SPECT of epileptic patients with normal imaging is all abnormal and the abnormality of EEG increases obvioously. Abnormal perfusion focus all exist in cerebral of generalized seizure. Abnormal perfusion focus of temporal lobe is 60.2 %.

关 键 词：癫痫 影像学 发作间期 SPECT 长程EEG 异常灌注灶 颞叶 

分 类 号：R742.1[医药卫生—神经病学与精神病学] R741.044[医药卫生—临床医学]