癫癎患者脑血流速度改变与癫癎灶定侧的关系

Relationship between the changes of cerebral blood flow and lateralization of epileptogenic focus

目的 :探讨癫发作间期脑血流变化对癫灶定侧的价值。方法 :4 7例癫病人发作间期行经颅多普勒超声脑血流速度测定 ,并与临床、脑电图定位和MRI/CT病灶对比分析。结果 :根据临床症状确定病灶侧的 19例病人中 ,病灶侧脑血流速度改变 (升高和降低 )的比率显著高于双侧脑血流速度对称者 ;在脑电图确定病灶侧的 2 4例病人中 ,病灶侧脑血流速度升高比率显著高于脑血流速度降低和双侧脑血流速度对称者 ;在MRI确定病灶侧的 13例病人中 ,病灶侧脑血流速度增快 7例 ,减慢 2例 ,双侧血流速度对称 4例。结论 :癫病人一侧脑血流速度增高 ,高度提示癫病灶侧。

Objective :To evaluate the values of interictal cerebral blood flow(CBF) changes in the lateralization of epileptogenic focus.Methods:Interictal CBF velocities were measured by transcranial Doppler Sondography in 47 patients with epilepsy.The findings were compared with the clinical manifestations,interictal EEG and MRI/CT.Results:In 19 patients with focus lateralized by clinical manifestations,the percentage of CBF increase or decrease on the focus side was significantly higher than that of bilateral symmetric CBF.In 24 patients with epileptogenic focus lateralized by EEG,the percentage of CBF increase on the focus side was significantly higher than that of CBF decrease and bilateral symmetric CBF.In 13 patients lateralized by MRI,CBF increased on the focus side in 7 patients and decreased in 2 ones,bilateral symmetric CBF was noted in 4 patients.Conclusion:Unilateral increase of CBF might predict the side of epileptogenic focus.