早期全身强直阵挛发作进展为颞叶癫癎的相关信息预测一EEG、SPECT与神经影像学的临床研究  

The forecast of related information of early GTCS developing into temporal lobe epilepsy The study of clinical and long-term monitoring EEG and interietal SPECT and imaging

作　　者：王为民[1] 张永琴[1] 凡振玉[1] 杨玉霞[1] 党小利[1] 宋文珺[1] 刘亚青[1] 吴银瓶[1] 叶江[1] 

机构地区：[1]兰州大学第二医院癫癎中心甘肃省癫癎治疗基地,甘肃兰州730030

出　　处：《癫痫与神经电生理学杂志》2012年第6期347-351,共5页Journal of Epileptology and Electroneurophysiology(China)

摘　　要：目的：探讨早期全面性强直阵挛发作（GTCS）与EEG、单光子发射断层扫描（SPECT）和神经影像学表现方面进展为颞叶癫癎（TLE）的相关信息。方法：总结100例GTCS临床、长程EEG、发作间期SPECT与神经影像学异常的检查资料。结果：男性62例，女性38例。平均年龄（19．0±13．2）岁，平均病程（1．3±1．4）年，有明确病因者占61％。长程EEG异常者占85％，表现有痫样放电者占76％，颞叶癎样放电型27例、颞叶扩散癎样放电型19例；SPECT异常90例，其中低灌注灶者占83％，高灌注灶者占2．2％，高一低灌注灶者占5．6％。异常灌注灶颞叶型占49％。异常灌注灶共153个，其中颞叶96个占62．7％；影像学异常44％，其中颞叶异常占40％。综合分析颞叶癎样放电46例，颞叶异常灌注灶62例和颞叶影像学病变40例。结论：早期GTCS患者的长程EEG、发作间期SPECT和影像学的颞叶异常，三者分析预测有46％～49％的病例如治疗难以控制的GTCS，可有发展为颞叶癫癎的倾向性。早期完全控制继发性GTCS具有相对防治颞叶癫癎的重要意义。Objective：To discuss related information of early GTCS and long-term EEG monitoring EEG and interictal SPECT imaging in patients with epilepsy. Methods： 100 cases with GTCS were all ex- amining with long-term EEG monitoring, interictal SPECT imaging and CT/MRI. Results.. The patients （included 62 men and 38 women whose mean age was 18.3 years,the average onset course was 1.1 years and 61% of them had definite causes. Abnormal long-term EEG took up 85 % and epileptic discharge took up 76%. 27 cases showed temporal discharge and 19 cases showed temporal related discharge; 90 cases （83 %） showed interictal SPECT imaging abnormal hypoperfusion,and abnormal temporal perfusion was 49% and abnormal temporal related perfusion was 37%. 153 cases suffered from abnormal perfusion fo- eus,inctuding 96 62.7% in temporal lobe; abnormal CT/MRI was 44% and abnormal temporal 40%. Comprehensive analysis was based on temporal related discharge in 46 cases and abnormal temporal lobe perfusion focus in 62 cases and temporal lobe lesions in 40 cases. Conclusion.. Early GTCS in long-term EEG monitoring and interictal temporal lobe SPECT CT/MRI and abnormal, three kinds of analysis and prediction show that 46 %-49 % of the cases who are found difficult to control GTCS tent to TLE. Early complete control of second GTCS has obvious significace to relatively prevent and control TLE.

关 键 词：早期 全面性强直阵挛发作(GTCS) 颞叶癫癎 EEG 发作间期 SPECT 影像学 预测 相关信息 

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]