Clinical Study Of Partial Epilepsy With Patients In Long-term Control Of Antiepileptic Drugs (70 Case)-Dynamic Changes Of Interictcal SPECT And V-EEG

Objective:To discuss the result of repair of abnormal perfusion foci of patients with Partial epilepsy in long-term controled with antiepileptic drugs (AEDs) by single photon emission computed tomography (SPECT) interictcally. Methods:The 70 case with AEDs treatmented and twice with interictcal SPECT, long-term V-EEG and CT/MRI were performed. Results:The average time of whole ictcal control was 24 months.The average age of the patients was 11.The average course was 1.3 years. The cases of etiology dear-cut were 38(household history 3 cases, perinatal stage injure 8 case, febrile convulsion 5 case, brain trauma 5 cases, brain operation 1 cases, central nervous system infection history 5 cases, many etiology 11 cases). Before treatment the ROI of interictcal SPECT abnormal was 84.3%,V-EEG abnormal was 88.6%(among epileptic discharges was 96.8%) and CT/MRI abnormal was 18.6%.After treatment interictcal SPECT normal increased 27.2%(P<0.05) and abnormal perfusion foci decreased 41.5%.V-EEG normal increased 22.8%(P<0.05) and epileptic discharges decreased 45.0%. Conclusions:The AEDs can reduced abnormal perfusion foci and epileptic discharges of Partial epilepsy with patients and abnormal perfusion foci have many kinds of forms of dynamic changes and part of abnormal perfusion foci can repaired. Purpose:To evaluate SPECT and long-term EEG in localization of focal epilepsy with long-term control of antiepileptic drugs through comparison between interictal SPECT and long-term EEG. Methods:Seventy patients with focal epilepsy were examined by interictal SPECT, long-term EEG and CT/MRI. Results:Interictal SPECT abnormality in 59 patients(84.3%). hyperperfusion showed in 25 patients(35.7%), Hypoperfusion in 33(47.2%) and hyper-hypotrasfusion in 1(1.4%).A total of 106 focus were abnormal perfusion, including 45 on temporal lobe,23 on frontal lobe,22 on parietal lobe and 10 on occipital lobe. Additionally,6 abnormal focus were distributed on basal ganglia and 1 on cerebellum. EEG abnormality in 62 patients(88.6%),epileptiform discharge in 60 cases(96.8%),including focal discharge in 39 cases and widespread in 21 cases. CT/MRI abnormality in 13 cases(18.6%).In the association of SPECT abnormal focus and EEG epileptiform discharge zones,the conforimity type,similarity type and unrelated type took up 15 cases(42.9%),13 cases(37.1%) and 7 cases(20.0%) respectively.Conclusion:The abnormal focus on temporal lobe are more than that on any other lobes in patients of interictal SPECT with long-term control of antiepileptic drugs. Focal epileptic discharge was the main performance of Long-term EEG. There is rather low correlation between abnormal focus of SPECT and epileptogenic zones of EEG in patients with long-term control of antiepileptic drugs. In clinical work we should combine SPECT with EEG to analyse, so that we could improve the accunacy to locate the epileptogenic focus.