额叶癫痫诊断──形态与功能定位的对比

本文对28例额叶癫痫病人的EEG、CT、SPECT检查的定位结果进行了对比研究，结果显示：85．7％的病人在发作间期和／或发作期EEG有额叶定位的征象，其中70％的患者两项结果一致，两者结合可提高定位诊断阳性率及准确率。CT检查仅42．9％发现额叶损害，但仍是重要辅助诊断手段，2例EEG不定位于额叶，CT发现额叶病变。11例SPECT检查中10例有额叶血流灌注异常，其中8例与EEG结果一致，但SPECT的范围多超出额叶，表明SPECT检查在额叶癫痫功能定位方面较敏感，但欠精确。提示EEG、SPECT、CT三者形态与功能定位相结合，对额叶癫痫诊断有较大意义，且有助于进一步进行深部电极精确定位检查及治疗方法选择。

Diagnosis of Frontal Lobe Epilepsy Comparison of Functional and Structural Methods in Localization

The correlations of EEG with CT and SPECT in 28 patients with frontal lobe epilepsy were studied. All patients had seizures of frontal lobe originated characteristics. Routine EEG, prolonged EEG (video-EEG or ambulatory EEG monitoring) and CT scan were performed in all, and 99m-TC (HM-PAO) SPECT in 11 cases. Ictal EEG was recorded in 20 cases. Results showed: Frontal lobe locarlization was revtaled by interictal and/or ictal EEG in 85.7% (24/28) patients, of those 70% patients had good correlation between interictal and intal EEG. Frontal lobe lesions were only found in 12 of the 28 patients (42.9%) by CT scan, of those 2 cases had no focal abnormalities on EEG, indicating CT scan is a significant complementary method for localization in patients with frontal lobe epilepsy. Abnormal tracer uptake was identified in all patients with SPECT which were related to frontal lobe in 10 cases, and correlated to EEG foci in 8 cases. However, all of abnormal SPECT areas were extented beyond frontal lobe. It is suggested that SPECT be more sensitive but less precise than EEG and CT scan in localization for frontal lobe epilepsy. It is necessary to use both functional and structural methods (EEG. SPECT. CT) for localization of frontal lobe epilepsy.