额叶癫痫的诊断形态与功能定位的对比

Diagnosis of frontal lobe epilepsyComparison of functional and structural methods in localization.

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。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检查在额叶癫痫定位方面较敏感，但欠精确。提示ＥＥＧ、ＳＰＥＣＴ、ＣＴ三者相结合。

The correlations of EEG with CT and SPECT in 28 patients with frontal lobe epilepsy were studied.Results showed:Frontal lobe localization was revealed by interictal and/or ictal EEG in 85.7% (24/28) patients.The two methods that were combined improved positive rate and exact rate for localization.Frontal lobe lesions were only found by CT scan in 42.9% (12/28) patients,indicating CT scan is still a significant complementary method for localization in patients with frontal lobe epilepsy.Frontal abnormal tracer uptake was identified in 10 patients with SPECT,and correlated to EEG foci in 8 cases.However,all of abnormal SPECT areas were extented beyond frontal lobe.It is suggested that SPECT is 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.