39例复杂部分性发作癫灶的PET与EEG定位诊断比较

目的 :探讨临床表现不同的癫复杂部分性发作 (CPS)与正电子发射断层扫描 (PET)检查病灶定位的相关性。方法 :39例CPS病人经PET、磁共振成像 (MRI)、录像 脑电监测 (Video EEG)检查 ,并对各种检查和临床表现进行比较分析。结果 :PET和EEG二者完全符合和部分符合均为 31% ,15例不符病例中 ,12例为PET有定位价值而EEG不能定位。仅表现为复杂部分性发作而无继发性全身性强直阵挛发作 (GS)者的 71%的病例 ,PET定位于单侧颞叶 ,表现为CPS继发GS者的 81%为颞顶、颞枕区病灶。结论 :CPS不继发全身性发作的患者 ,病灶多局限于一侧颞叶 ,如发作期和发作间期脑电图均正常 ,更应考虑病灶位于颞叶内侧面 ,或边缘系统 ;CPS继发GS的患者病灶多位于颞叶外侧面与顶、枕交界区。

Comparative study of PET and EEG location in 39 epilepic patients with complex partial seizures.

Objective: To study the relation between PET and EEG location in patients with complex partial seizures.Methods: PET, MRI and video EEG were done in 39 epileptic patients with complex partial seizure, and the results and the clinical manifestation were analyzed comparatively.Results: The complete and partial coincidence rate of EEG and PET location was 31% respectively. That EEG location had not coincidence with PET was noted in 15 patients ,in 12 of the 15 patients, PET had location value but EEG had not. Unilateral temparal lobe focus was located by PET in 71% patients showing only complex partial seizure but not accompanied by generalized tonic clonic seizures. In patients showing complex partial seizure and secondary generalized seizures,81% of them showed focus in temporal parrietal and temporal occipital region.Conclusions: In patients with CPS but without GTS, the focus was mostly located in unilateral temporal lobe, esp, in the medial temporal lobe or the limbic system if the ictal and the interictal EEG was normal, but in those patients with CPS and GTS, the focus was located in the lateral temporal parietal lobe or temporal parietal occipital areas.