90例围产期异常的癫痫患者的临床、SPECT、EEG与影像学研究

目的：探讨围产期异常癫痫患者的临床特征、发作间期SPECT、V-EEG及CT和（或）MRI特点。方法：对90例围产期异常的癫痫患者进行发作间期SPECT、V-EEG和影像学检查并分析其与临床的关系。结果：本组90例中存在16种围产期高危因素，起病年龄≤14岁者占88％。V-EEG异常81例（90％），呈痢样放电74例，定位率为37％。SPECT异常78例（87％）；低灌注38例（49％），高灌注33例（42％），高-低灌注7例（9％），总异常灌注灶120个，其中颞叶占54个（45％）。影像学异常45％。结论：围产期异常的癫痫患者多在儿童期发病；V-EEG痴样放电以广泛性多见。发作间期SPECT异常灌注多见于颞叶。影像学表现以颞叶萎缩和脑发育障碍多见。

Clinical features , interictal SPECT, EEG and imaging in 90 epileptics with perinatal abnormalities

Objective：To explore clinical features, interictal SPECT, Long-term EEG and imaging findings in patients with epilepsy due to perinatal abnormality. Methods.. Interictal SPECT, Long-term EEG and image scan were performed in 90 epileptics with perinatal abnormalitiy. Results.. As many as 16 risk factors were found in 90 cases about perinatal abnormalitiy. Patients whose age of onset was 14 years or less accounted for 88%. Abnormal EEG was in 81cases（90%）,including epileptic discharge in 74 ca- ses and localization rate in 37%. Interictat SPECT abnormality rate was 87%. Hypoperfusion foci oc- curred in 38 cases （49%）, hyperperfusion foci in 33 cases （42%） and high-low perfusion foci in 7 cases （9%）. It also showed abnormal perfusion of 120 foci in all, of which 54 （45%） were in the temporal lobe. The abnormality rate of image was 45~/oo. Conclusion： In patients with epilepsy due to perinatal ab normalities, they onseted in childhood mostly. Generalized epileptic discharge was the main performance of Long-term EGG. Abnormal interictal SPECT was rather high and its foci were more common in tempo- ral lobe. Imaging findings were mainly characterized by brain atrophy in tehaporal lobe and cerebral depauperate.