원저 : 신피질성 간질에서 발작기 99mTc - HMPAO 뇌혈류 SPECT의 간질병소 국소화 성능 ( The Performance of Ictal Brain SPECT Localizing for Epileptogenic Zone in Neocortical Epilepsy ) () |
Author |
김은실(Eun Sil Kim),이동수(Dong Soo Lee),현인영(In Young Hyun),정준기(June Key Chung),이명철(Myung Chul Lee),고창순(Chang Soon Koh),이상건(Sang Kun Lee),장기현(Kee Hyun Chang), |
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Affiliation |
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Abstract |
The epileptogenic zones should be localized precisely
before surgical resection of these zones in intractable
epilepsy. The localization is more difficult in
patients with neocortical epilepsy than in patients
with temporal lobe epilepsy. This study aimed at
evaluation of the usefulness of ictal brain perfusion
SPECT for the localization of epileptogenic zones in
neocortical epilepsy. We compared the performance of
ictal SPECT with MRI referring to ictal scalp
electroencephalography (sEEG). Ictal Tc-99m-HMPAO SPECT
were done in twenty-one patients. Ictal EEG were also
obtained during video monitoring. MRI were reviewd.
According to the ictal sEEG and semiology, 8 patients
were frontal lobe epilepsy, 7 patients were lateral
temporal lobe epilepsy, 2 patients were parietal lobe
epilepsy, and 4 patients were occipital lobe epilepsy.
Ictal SPECT showed hyperperfusion in 14 patients(67%)
in the zones which were suspected to be epileptogenic
according to ictal EEG and semiology. MRI found
morphologic abnormalities in 9 patients(43%). Among the
12 patients, in whom no epileptogenic zones were
revealed by MR1, ictal SPECT found zones of
hyperperfusion concordant with ictal sEEG in 9
patients(75%). However, no zones of hyperperfusion were
found in 4 among 9 patients who were found to have
cerebromalacia, abnormal calcification and migration
anomaly in MRI. We thought that ictal SPECT was useful
for localization of epileptogenic zones in neocortical
epilepsy and especially in patients with negative
findings in MRI. |
Keyword |
Neocortical Epilepsy, Ictal SPECT, 99mTc-HMPAO |
Full text Article |
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