대한핵의학회지 (1967년~2009년)
대한핵의학회지 1995;29(4)445~6
원저 : 신피질성 간질에서 발작기 99mTc - HMPAO 뇌혈류 SPECT의 간질병소 국소화 성능 ( The Performance of Ictal Brain SPECT Localizing for Epileptogenic Zone in Neocortical Epilepsy )
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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),
Affiliation
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
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