A Clinical Study Of Refractory Epilepsy

Part 1 THE CLINICAL INVESTGATION OF LOCATION OF REFRACTORY EPILEPSY FOCUS WITH PET ANDSPECTObjective: To explore the localization value of interictal 18F-FDG-PET, interictal and ictal SPECT. Methods: We chosen 32 epilepsy patients who were diagnosed by clinical symptom and EEG. The epilepsy focus was localized with interictal 18F-FDG-PET, interictal and ictal SPECT. The diagnostic value of interictal 18F-FDG-PET, interictal and ictal SPECT was compared based on the EcoG and DEEG. Results: The ratio of accuracy and sensitivity of interictal 18F-FDG-PET was 84.8% and 92.5%, those of interictal SPECT was 58.7% and 71.8%, those of ictal SPECT was 91.6% and 95.0%. Conclusion: The ratio of accuracy and sensitivity of interictal 18F-FDG-PET and ictal SPECT was better than interictal SPECT (P<0. 05) .Part 2 CLINICAL RESEARCH ABOUT EPILEPTICFOIC ON THE RADIOSURGERY FORINTRACTABLE TEMPORAL EPILEPSYObjective: To explore the radiosurgery method and treatment effect ofRefractory epilepsy; PET; SPECT; Localizationintractable temporal epilepsy. Methods: The temporal epilepsy focus was localized by clinical manifestation, EEG, MR and PET in 96 patients. We compared the treatment effects between low dose radiation (10-13GY) and stereotactic selective amygdalohippocampectomy (30-50GY) by Gamma-knife. And compared the treatment effects between unilateral temporal focus and bilateral temporal focus. Results: All patients followed up 1-5 years , mean 27. 3 months. The ratio of recovery was 45.8% by low dose radiation in unilateral temporal focus, those of stereotactic selective amygdalohippocampectomy was 72. 5%, those of bilateral focus was 46.9%. There was not mortality and deformity. Conclusion: the radiosurgery method of intractable temporal epilepsy by Gamma-knife was safe and effective. Treatment effects of low dose radiation add stereotactic selective amygdalohippocampectomy were better than single low dose radiation (P <0. 05) , And the treatment effects were better in unilateral temporal focus than bilateral temporal focus (P<0. 05) .