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1.
癫痫发作间期和亚临床发作期脑SPECT痫灶定位?… 总被引:1,自引:0,他引:1
目的:研究癫痫亚临床发作期和发作间期脑SPECT的痫灶定位诊断价值。方法:建立亚临床发作期脑血流灌注显像方法,与间期显像对比分析定位;并结合脑CT、EEG、ECoG和疗效综合评价其痫灶定位诊断价值。结果:间期SPECT阳性率、准确率、灵敏度分别为:90.91%、77.27%、89.47%,亚临床发作期分别为:95.45%、90.91%、100%,优于传统定位诊断。亚临床发作期病灶放射性摄影比值也有 相似文献
2.
额叶癫痫的诊断—形态与功能定位的对比 总被引:2,自引:0,他引:2
本文对28例额叶癫痫病人的EEG,CT,SPECT检查定位结果进行了对比研究,结果显示:85.7%的病人发作间期和/或发作期EEG有额叶定位征象,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,仍是重要辅助诊断手段。 相似文献
3.
目的:探讨EEG、SPECT和PET在癫痫病灶定位诊断中的价值和三者之间的关系。方法:120例经MR和CT检查除外脑部肿瘤及脑血管畸形的癫痫病人,经电视录像-动态脑电图监测、SPECT和PET检查定位,比较三者定位方法的灵敏度和一致性。结果:PET定位的阳性率为908%;SPECT为742%;动态脑电图为60%,三者的完全一致性为225%,部分一致性为512%。在完全一致性和部分一致性方面,SPECT与PET为783%,EEG与SPECT、EEG与PET分别为624%和708%。4例皮质脑电图(ECoG)证实局灶性癫痫样放电与PET检出的葡萄糖代谢减低区完全一致。结论:PET是诊断癫痫病灶灵敏而有效的方法,对癫痫病灶的定位价值优于EEG、MR、CT和SPECT。EEG、SPECT和PET三者有较高一致性,其中以PET与SPECT的一致性最高。 相似文献
4.
临床上应用EEG、SPECT、ECoG进行致痫灶定位有一定差异性,我们应用PET对10例顽固性癫痫术前定位,来探讨FDG—PET低代谢区与实际癫痫灶的相符合程度,从而衡量其定位的准确性与特异性。方法:10例顽固性癫痫患者,强直阵挛性发作1例,复杂部分... 相似文献
5.
多发性抽动症患者脑SPECT与CT/MR及EEG比较性研究 总被引:4,自引:0,他引:4
目的探讨脑SPECT、CT/MR、EEG对多发性抽动症(TS)的临床诊断价值。方法对35例TS患者进行99m锝-双半胱乙酯(9mTc-ECD)脑SPECT显像,并于2周内行CT/MR和EEG检查。结果脑SPECT对TS诊断的灵敏性、特异性、准确性分别为714%、100%、8367%;EEG检查的阳性率486%,明显低于SPECT(P<005);CT仅发现1例侧脑室轻度增大。结论SPECT脑显像对确定TS的病变部位优于EEG和CT/MR。 相似文献
6.
癫痫放电灶的EEG,SPECT与PET定位研究 总被引:2,自引:0,他引:2
目的:探讨EEG、SAPECT和PET在癫痫病灶定位诊断中的价值和三者之间的关系。方法:120例经MR和CT检查除外脑部肿瘤及脑血管畸形的癫痫病人,经电视录像-动态脑电图监测、SPECTT PET检查定位,比较三者定位方法的灵敏度和一致性。结果:PET定位的阳性率为90.8%;SPECT为74.2%;动态脑电图为60%三者的完全一致性为22.5%,SPECT、EEG与PET分别为62.4%和70. 相似文献
7.
蝶骨电极检查对颞叶癫痫致痫灶定位的意义 总被引:1,自引:0,他引:1
分析52例蝶骨电极对颞叶癫痫致痫灶的手术定位,发现蝶骨电极均能查出痫样放电,局限于颞叶者为90.38%(P<0.01)。手术中皮层电图(ECoG)及深部电极(DCoG)描记,证实全部病例颞叶表面或海马、杏仁核均有痫样放电,表明蝶骨电极检查的可靠性,不仅可提高颞叶癫痫脑电图的阳性率且有助于手术定位 相似文献
8.
目的:探讨发作间期18F-脱氧葡萄糖(FDG)正电子发射断层扫描(PET)和99mTc-己撑半脱氨酸(ECD)单光子发射断层扫描对顽固性颞叶癫痫(TLE)的定位诊断价值。方法:53例脑电图(EEG)定位明确的顽固性TLE患者分别行发作间期18F-FDGPET和99mTc-ECDSPECT检查。其中21例磁共振(MRI)显示有结构性病变并与EEG定位结果一致。结果:MRI异常组均在PET和SPECT相应部位出现低代谢和低灌注表现。MRI正常组,PET定位准确性为84.5%,显著高于SPECT的56.3%(P<0.05)。结论:对于无结构性病变的颞叶癫痫,发作间期PET检查有较高的定位诊断价值,SPECT的临床意义相对较小 相似文献
9.
皮层和深部电极监测致痫灶切除治疗顽固性癫痫 总被引:1,自引:0,他引:1
目的:研究顽固性癫痫病人致痫灶的术前和术中的定位方法。方法:34例病人接受了致痫灶切除术。作者根据(1)癫痫发作的临床特点。(2)电生理检查(包括EEG、长时脑电监测),(3)影像学检查(CT、MR和DSA等)进行术前定位,术中应用ECoG和部电极对致痫灶行精确定位。结果:术后经3个月-3年随访,无发作16例,占47.1%,改善17例,占50%;无变化1例,占2.9%。结论:术前EEG,术中ECO 相似文献
10.
《立体定向和功能性神经外科杂志》2001,(4)
PET、EEG、MRI在术前癫痫灶定位价值中的对比研究欧阳辉 邱炳辉 漆松涛 黄祖汉 吴湖炳 王全师 摘要 目的:探讨术中皮层脑电图(ECoG)、术后组织病理和随访结果为标准,比较发作间期18 F-FDG PET显像、EEG、MRI在难治性癫痫外科手术前癫痫灶定位中的价值。方法:术前均行发作间期1 8F-FDG PET脑显像、2~3次 EEG和 MRI检查,术中行ECoG检查,以PET和ECoG定位的癫痫灶范围行癫痫灶切除或多处软脑膜处横纤维切断术,术后切除病变组织行病理检查与外科治疗效果进行随访,比… 相似文献
11.
Neuronal migration disorders are the result of disturbed brain development. In such disorders, neurons are abnormally located. In diagnosing these conditions, magnetic resonance imaging is superior to any other imaging technique. This enables us to improve our knowledge of the clinical correlates of neuronal migration. With reference to migrational disorder, a retrospective study of all 303 patients with epileptic seizures referred for magnetic resonance imaging during a 3-year period was performed, 13 patients (aged 12-41, mean age 27) were identified. They represent 4.3% of the entire study group. Of the patients with known epilepsy, 6.7% and of the mentally retarded, 13.7% had migrational disorders. Four patients had schizencephaly as the dominant finding, one was classified as hemimegalencephaly, 2 had isolated heterotopias, and 6 had localized pachy- and/or poly-microgyria. The clinical pictures are complex. Ectopias of grey matter are recognised foci of epilepsy, but from an epileptological and a clinical viewpoint little attention has been given to these disorders. The present study shows that malmigration is not rare in epilepsy patients, especially not in the mentally retarded. 相似文献
12.
Berkan Guleyupoglu Pedro Schestatsky Dylan Edwards Felipe Fregni Marom Bikson 《Journal of neuroscience methods》2013
Transcranial Electrical Stimulation (tES) encompasses all methods of non-invasive current application to the brain used in research and clinical practice. We present the first comprehensive and technical review, explaining the evolution of tES in both terminology and dosage over the past 100 years of research to present day. Current transcranial Pulsed Current Stimulation (tPCS) approaches such as Cranial Electrotherapy Stimulation (CES) descended from Electrosleep (ES) through Cranial Electro-stimulation Therapy (CET), Transcerebral Electrotherapy (TCET), and NeuroElectric Therapy (NET) while others like Transcutaneous Cranial Electrical Stimulation (TCES) descended from Electroanesthesia (EA) through Limoge, and Interferential Stimulation. Prior to a contemporary resurgence in interest, variations of transcranial Direct Current Stimulation were explored intermittently, including Polarizing current, Galvanic Vestibular Stimulation (GVS), and Transcranial Micropolarization. The development of these approaches alongside Electroconvulsive Therapy (ECT) and pharmacological developments are considered. Both the roots and unique features of contemporary approaches such as transcranial Alternating Current Stimulation (tACS) and transcranial Random Noise Stimulation (tRNS) are discussed. Trends and incremental developments in electrode montage and waveform spanning decades are presented leading to the present day. Commercial devices, seminal conferences, and regulatory decisions are noted. We conclude with six rules on how increasing medical and technological sophistication may now be leveraged for broader success and adoption of tES. 相似文献
13.
Hepatic Considerations in the Use of Antiepileptic Drugs 总被引:5,自引:4,他引:1
Summary: Virtually all of the major antiepileptic drugs (AEDs) can cause hepatotoxicity, although fatal hepatic reactions are rare. The mechanisms, incidences, and risk profiles for such reactions differ from drug to drug. With carbamazepine and phenytoin, hepatotoxicity may be due to drug hypersensitivity. Although the profiles of patients at risk have not been well-defined for these two antiepileptic drugs, it would appear from reports in the literature that older adolescents and adults are at higher risk than children of developing serious or fatal hepatotoxicity. Once hepatotoxicity develops, mortality rates are 10–38% with phenytoin and 25% for carbamazepine. The risk profile for valproate fatal hepatotoxicity has been more clearly defined. Those at primary risk of fatal hepatic dysfunction are children under the age of 2 years who are receiving multiple anticonvulsants and also have significant medical problems in addition to severe epilepsy. The risk is considerably lower for patients over the age of 2 years on valproate monotherapy. In contrast to the risk profile with other AEDs, adults receiving valproate as monotherapy have the lowest risk of hepatotoxicity. Fatal hepatic dysfunction coincident with valproate may be the result of aberrant drug metabolism. Concomitant use of AEDs that induce microsomal P450 enzymes (e.g., phenytoin and phenobarbital) may enhance the production of a toxic metabolite, and hence the greater risk of hepatotoxicity with polypharmacy. 相似文献
14.
Summary: Vascular malformations (VMs) are associated with epilepsy. The natural history of the various VMs, clinical presentation, and tendency to provoke epilepsy determine treatment strategies. Investigations have probed the mechanisms of epileptogenesis associated with these lesions. Electrophysiologic changes are associated with epileptogenic cortex adjacent to VMs. Putative pathophysiologic mechanisms of epileptogenesis include neuronal cell loss, glial proliferation and abnormal glial physiology, altered neurotransmitter levels, free radical formation, and aberrant second messenger physiology. 相似文献
15.
S. FELDMAN 《Epilepsia》1971,12(3):249-262
16.
Neonatal Seizures: Problems in Diagnosis and Classification 总被引:6,自引:5,他引:1
Eli M. Mizrahi 《Epilepsia》1987,28(S1):S46-S54
Summary: The clinical identification of neonatal seizures is critical for the recognition of brain dysfunction; however, diagnosis is often difficult because of the poorly organized and varied nature of these behaviors. Current classification systems are limited in their ability to communicate motor, autonomic, and electroencephalo-graphic features of seizures precisely and to provide a basis for uniform effective diagnosis, therapy, and determination of prognosis. Recent investigations of neonates, utilizing bedside electroencephalographic/polygraphic/ video monitoring techniques, have provided the basis for improved diagnosis and classification of seizures in the newborn. These studies have demonstrated that not all clinical phenomena currently considered to be seizures require electrocortical epileptiform activity for their initiation or elaboration. In addition, the specific clinical character of the phenomena considered to be seizures, the clinical state of the infant, and the character of the EEG indicate the probable pathophysiological mechanisms involved and suggest probable etiologies, prognosis, and therapy. Similarities between animal models that demonstrate reflex physiology and neonates with motor automatisms and tonic posturing suggest that these clinical behaviors may not be epileptic in origin but, rather, primitive movements of progression and posture mediated by brainstem mechanisms. Although not all clinical behaviors currently considered to be neonatal seizures may have similar pathophysiological mechanisms, they are clinically significant because they all indicate brain dysfunction. 相似文献
17.
David W. Chadwick 《Epilepsia》1987,28(S2):S12-S17
Summary: For decades, therapeutic tradition has promoted the concept of polypharmacy in the management of epilepsy. In recent years, however, studies have shown that, for most patients, monotherapy can provide comparable or better seizure control than administration of multiple anticonvulsants, while diminishing the potential for adverse reactions, drug interactions, and poor compliance. Valproate is an important monotherapeutic agent that is highly effective in the control of idiopathic primary and secondarily generalized epilepsies, and partial seizures that do not generalize. Comparative studies have found that valproate is at least as effective as phenytoin and carbamazepine in the treatment of generalized and partial seizures. Given the similar efficacy, other factors such as pharmacokinetics and side effects may therefore determine anticonvulsant selection for monotherapy. 相似文献
18.
Erik R Kandel 《L'évolution Psychiatrique》2002,67(1):12
In an attempt to place psychiatric thinking and the training of future psychiatrists more centrally into the context of modern biology, the author outlines the beginnings of a new intellectual framework for psychiatry that derives from current biological thinking about the relationship of mind to brain. The purpose of this framework is twofold. First, it is designed to emphasize that the professional requirements for future psychiatrists will demand a greater knowledge of the structure and functioning of the brain than is currently available in most training programs. Second, it is designed to illustrate that the unique domain which psychiatry occupies within academic medicine, the analysis of the interaction between social and biological determinants of behavior, can best be studied by also having a full understanding of the biological components of behavior. 相似文献
19.
Carbamazepine Efficacy and Utilization in Children 总被引:4,自引:3,他引:1
W. Edwin Dodson 《Epilepsia》1987,28(S3):S17-S24
Summary: Carbamazepine is effective for preventing partial and generalized tonic-clonic seizures in children. Although absence epilepsies are more common in children than adults, an estimated 80% of children with epilepsy have seizure types or epilepsies that are potentially responsive to carbamazepine. The differential diagnosis of ictal staring is an especially important issue in children because absence and atypical absence seizures are more prevalent in children than adults. Age-related pharmacokinetic differences and drug interactions are major considerations in children. On average, children have higher clearance rates of carbamazepine, shorter half-lives, and higher ratios of carbamazepine-10, 11-epoxide to carbamazepine than adults. In addition, children with severe epilepsy are more likely to require multiple-drug therapy, which can lead to complex drug interactions. When carbamazepine is administered along with valproate, drug protein binding interactions can cause intermittent side effects. 相似文献
20.