隐原性癫痫的病因学研究

采用现代影像学、电生理学、神经化学和免疫学技术等综合方法,对353例隐原性癫痫的病因进行了研究.研究结果,120例行颅脑CT检查,发现可导致癫痫发作的各种器质性病变35例,占29.17%.81例行体感诱发电位(SEP)与听觉诱发电位(AEP)检查,发现SEP和AEP异常分别为27例,占33.33%.分别对24例行脑脊液3-甲氧基-4-羟基苯乙二醇(MHBG)、5-羟吲哚乙酸(5-HIAA)和高香草酸(HVA)高效液相色谱分析,发现MHBG、5-HIAA和HVA三项指标都有显著改变.100例行血清免疫球蛋白、补体C_3、E玫瑰花环形成率和淋巴细胞转化率检查,结果均有明显改变.脑组织的器质性病变提示隐原性癫痫有其发病的组织学基础.脑诱发电位异常提示脑生物电活动的功能改变,它可由CT所见或难以分辨的脑组织病变所致,也可由局部脑组织代谢障碍所致.MHBG、5-HIAA和HVA的改变提示该病的发作与脑内单胺类神经递质有关.补体C_3的升高,提示该病的发作与补体介导的免疫反应有关.

THE ETIOLOGIC INVESTIGATION OF LALENT EPILEPSY

Using several methods, we ivestigated 353 latent epileptics who were physically normal. Cranial CT scanning showed that 35 out of 120 cases had structural disorders which might be the causes of epilepsy. On somatosensory evoked potentials(SEP) and auditory evoked potentials(AEP),one third of 85 patients had abnormal manifestations which perhaps were the results of brain structural disorders that could not be detected by CT scanning or probably were related to metabolic disorders of the brain.The concention of 3-methoxy-4-hydroxy-benzoglycols(MHBG), 5-hydroxy-indolyacetic acid(5-HIAA) and homovanillic acid(HVA)in CSF suggested that epileptic attacks had something to do with the disorders of monoamine metabolites. The measurements of immunological foctors in 100 patients showed that epileptics were deficient in their immune system .Morover,the immune reaction induced by circulating immune complex probably was one of the mechanisms leabing to epilepsy.