난치성 측두엽간질의 발작기 국소뇌혈류 SPECT

Abstract

Refractory temporal lobe epilepsy is a disease of non-response to medical treatment, and the surgical resection of the epileptic focus is a treatment of choice. The ictal regional cerebral blood flow(rCBF) SPECT with Tc-99m ECD was done preperatively in ten refractory temporal lobe epilepsy patients. Engel's surgical outcome of one year after surgical resection of epileptic focus were analysed with ictal rCBF SPECT findings. Tc-99m ECD were labeled anticipatively, and placed in patient's bed of the patient monitoring room, and were injected within 7 seconds of seizure onset. Seven interictal rCBF SPECT and six MRI were also performed. There was positive findings in six cases, of which five were increased rCBF, and remaining one revealed decreased rCBF at epileptic focus, and IA to ⅡB of Engel's surgical outcome were noticed. One case of four normal ictal rCBF SPECT showed decreased rCBF in interictal rCBF SPECT. Four cases of seven interictal rCBF SPECT showed normal findings. Five of nine MRI shows normal findings, in which abnormal ictal rCBF SPECT were noticed. As a conclusion, ictal rCBF SPECT could help to find out epileptic focus in refractory temporal lobe epilepsy.