小儿癫痫及其发作类型、频率与脑细胞葡萄糖代谢的相关性研究

Correlation between cerebral glucose metabolism and all sorts of paediatric epilepsy or seizure frequency

目的:探讨小儿癫痫及其发作类型、频率与癫痫灶脑细胞葡萄糖代谢的相关性。方法:对经临床、EEG及MRI检查确诊的86例癫痫患儿进行脑18F-FDGPET显像检测,以反映癫痫灶脑细胞葡萄糖代谢情况。结果:与对照组比,癫痫组脑PET显像异常(P<0.01);异常率为89.9%(77/86),其中72例发作间期为低代谢显像,5例发作期为高代谢显像。不同发作类型癫痫患儿脑PET显像异常的脑区不同,婴儿痉挛症和Lennox-Gastaut syndrome脑PET显像异常部位主要在双侧皮质,呈双侧大脑弥漫性皮质低代谢改变,复杂部分性发作患儿则主要为颞叶。脑PET显像异常与发作频率或病情呈正相关(P<0.01),即脑PET显像异常愈重,发作频率愈高或病情愈重;但与发病年龄无关(P>0.05)。结论:癫痫患儿脑细胞葡萄糖代谢异常;不同发作类型的癫痫患儿脑细胞葡萄糖代谢异常的脑区不同;脑PET显像异常与发作频率或病情呈正相关。

AIM： To investigate the correlation between cerebral glucose metabolism and paediatric epilepsy or seizure type and seizure frequency. METHODS： To observe the cerebral glucose metabolism in epileptogenic focus, ^18F- FDG positron emission computed tomography （PET） brain imaging tests were carried out in 86 cases of paediatric epilepsy diagnosed by EEG and MRI. RESULTS： Compared to control group, significantly statistical differences between children epilepsy group and control group in PET brain imaging were observed （P 〈 0. 01 ）. The PET brain imaging abnormal rate in epilepsy group was 89.9% （77/86）. In abnormal cases, decreased glucose metabolism was shown in 72 cases and ino creased glucose metabolism was shown in 5 cases. The abnormal PET in different brain districts implicated varieties of epilepsy. Most abnormal brain PET imaging sites in the cases of infantile spasms and Lennox - Gastaut syndrome were ob- served in bilateral cortex, bilateral brain showed diffuse cortical low metabolic changes, the children with complex partial seizures mainly in temporal lobe. The positive correlations between the abnormal intensity of PET imaging and the severity or seizure frequency were found （P 〈 0.01 ）. The more abnormal brain PET imaging was detected, the higher the frequency of attacks or the severer the disease processing was, but no correlation with age （ P 〉 0. 05） was observed. CONCLU- SION： Cerebral glucose metabolism of paediatric epilepsy is abnormal. The abnormal PET with varieties of epilepsy is found in different brain district. There is positive correlation between the abnormal intensity of PET imaging and the severity or seizure frequency of epilepsy.