PATTERNS OF POSTICTAL CEREBRAL BLOOD-FLOW IN TEMPORAL-LOBE EPILEPSY - QUALITATIVE AND QUANTITATIVE-ANALYSIS

被引:187
作者
ROWE, CC
BERKOVIC, SF
AUSTIN, MC
MCKAY, WJ
BLADIN, PF
机构
[1] AUSTIN HOSP,DEPT NEUROL,HEIDELBERG,VIC 3084,AUSTRALIA
[2] AUSTIN HOSP,COMPREHENS EPILEPSY PROGRAM,HEIDELBERG,VIC 3084,AUSTRALIA
[3] AUSTIN HOSP,DEPT NUCL MED,HEIDELBERG,VIC 3084,AUSTRALIA
关键词
D O I
10.1212/WNL.41.7.1096
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
We used single-photon emission computed tomography (SPECT) to study postictal cerebral blood flow (CBF) in 51 patients with temporal lobe epilepsy. There were 78 seizures studied, 77 by early postictal injection of Tc-99m HMPAO (delay from seizure onset = 4.3 +/- 4.5 min) and one by ictal injection. Increased focal temporal lobe uptake, predominantly confined to the anteromesial region, was present in 83% and declined rapidly over 5 minutes. Reduced activity in the lateral temporal lobe accompanied the mesial increase in 80% of studies, extending over much of the ipsilateral hemisphere and closely associated with the degree and extent of postictal EEG slow waves. These patterns enabled correct seizure localization by blinded analysis in 69% (31/45) of the patients with a unilateral EEG focus. The remainder showed bilateral or no changes. One of six patients with bitemporal EEG foci had unilateral perfusion changes. The positive predictive value for the correct localization of a unilateral focus by postictal SPECT was 97% (31/32). Postictal CBF imaging with SPECT can be used to support noninvasive electrographic localization and may decrease the need for invasive electrode studies.
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页码:1096 / 1103
页数:8
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