MRI阴性和PET阳性颞叶癫的临床特点及外科预后  

Clinical Characteristics and Surgical Outcome of MRI Negative, PET Positive Temporal Lobe Epilepsy

作　　者：胡杰[1,2] 冯睿[1] 潘力[1] 郎黎琴[1] 毛颖[1] 史之峰[1] 顾昕[2] 郭俊[2] 

机构地区：[1]复旦大学附属华山医院神经外科,200040 [2]复旦大学附属华山医院静安分院,200040

出　　处：《中国临床神经科学》2013年第3期317-320,347,共5页Chinese Journal of Clinical Neurosciences

摘　　要：目的探讨磁共振成像(MRI)阴性(MRI无明显异常)、正电子发射计算机断层扫描(PET)阳性(PET显示单侧颞叶明显低代谢)颞叶癫患者的临床特点以及外科预后。方法总结18例MRI阴性、PET阳性颞叶癫患者的临床发作症状学、神经结构、功能影像学、人口统计学特征等临床特点,以及外科治疗预后。结果在皮质脑电监护下接受标准前颞叶切除术后,MRI阴性、PET阳性颞叶癫患者的颞叶切除术长期预后良好。根据Engel分级,Ⅰ级比例达到66.7%(12例),Ⅰ级+Ⅱ级比例达到83.4%(15例)。结论在进行脑电图等综合术前评估后,MRI阴性、PET阳性颞叶癫是一类可接受外科治疗的癫类型;在PET阳性侧施行标准前颞叶切除术,可以获得长期良好的预后。Aim To investigate the clinical characteristics and surgical prognosis of magnetic resonance imaging （MRI） negative （i.e. no obvious anomaly on MRI）, positron emission tomography （PET） positive （i.e. unilateral temporal hypometabolism on PET） temporal lobe epilepsy （TLE）. Methods The semiology, structural and functional imaging, demography, clinical characteristics and surgical outcome of 18 cases of MRI negative, PET positive TLE were analyzed. Results After successful standard anterior temporal lobectomy （sATL） under the intraoperative electrocorticography （ECoG） monitoring, the prognosis of the cases with MRI negative, PET positive TLE were excellent. After operation, the patients who achieved Engel grade I outcome accounted for 66.7% and grade I＋II for 83.4%. Conclusion After comprehensive presurgical evaluation including EEG study and successful sATL, the cases with MRI negative, PET positive TLE are surgically treatable, showing excellent long-term prognosis.

关 键 词：磁共振成像 颞叶癫痫 正电子发射计算机断层扫描 前颞叶切除术 

分 类 号：R742.1[医药卫生—神经病学与精神病学]