Epilepsy Patients With Perinatal And Neonatal Abnormalities: Linical Features, Interictal SPECT, Video-EEG And Image

Part 1 Epilepsy patients with perinatal and neonatal abnormalities: clinical features, interictal SPECT, video-EEG and ImageObjective:The goals of this study were to assess the relation between perinatal or neonatal abnormal factors and epilepsy, and to explore their clinical features, interictal SPECT(Single-photo emission-computed), V-EEG (Viedo electroencephalogram) and imaging (CT/MRI, Computerized tomography or Magnetic imaging) findings features in patients with epilepsy due to perinatal or neonatal abnormalities. At the same time, we also assessed the value of interictal SPECT, V-EEG and CT/MRI in diagnosis and treatment of epilepsy.Methods:The present study was performed in 150 epilepsy, who were diagnosed at the Second Hospital of Lanzhou University, Epilepsy Center from February 2008 to February 2010. They all haved a abnormal history of perinatal or neonatal period based on the inclusion and exclusion criteria. We clearly record patients, the general condition, determined the seizure type, and investigated their findings of interictal SPECT, V-EEG and CT/MRI. Finally, we analyzed the sensitivities and specificities values of interictal SPECT, V-EEG and CT/MRI by SPSS 17.0 statistical software.Results:20 risk factors were found in 150 case about perinatal or neonatal period abnormalities, followed by premature birth, neonatal asphyxia, neonatal hypoxic ischemic encephalopathy and neonatal intracranial hemorrhage, et al. Patients whose age of onset was less than 14 years accounted for 88%. Seizure types included generalized tonic clonic seizures, complex partial seizures, simple partial seizures and secondary generalized tonic clonic seizures, respectively.11 cases were associated with mental retardation in 150 patients. Interictal SPECT abnormal was 85.3%.It showed hypoperfusion foci in 63 cases (49.2%), hyperperfusion foci in55 cases (43%), high-low perfusion foci in 10 cases (7.8%).And it also showed abnormal perfusion of 224 foci in all, of which 92 (41.1%) were in the temporal lobe. Abnormal V-EEG was in 132 cases(88%),including epileptic discharge 117(88.6%) cases, localization rate in 49 (37.1%) cases. The abnormal rate of image was 45%,importantly presented as brain atrophy and brain abnormal development. The positive rate was no significant difference between interictal SPECT and V-EEG(x2= 0.462, P= 0.497> 0.05). The positive rate had significant difference between interictal SPECT and CT/MRI.Conclusions:The most eoilepsy patients incidenced in childhood, expecially,who were following as history of perinatal or neonatal abnormalities. Their seizure type were similar between generalized seizures and partial seizures. The positive rate of interictal SPECT and V-EEG were higher than CT/MRI. Extensive epileptic discharge was the main performance for V-EEG. Imaging income mainly included cerebral atrophy and brain dysplasia. Temporal lobe lesions were the most common by interictal SPECT, V-EEG and CT/MRI localization. Therefore, clinicians must standardize the medical history taking, combine clinical seizure pattern, take interictal SPECT, V-EEG and CT/MRI and other tests, which should have great significance to clear the epilepsy diagnosis, classification, treatment and prognosis.Part 2 The consistency study of epileptic foci diagnosis on Interictal SPECT, V-EEG and CT/MRIObjective:To evaluate the consistency of interictal SPECT,V-EEG and imaging in the diagnosis of epileptic foci.Methods:The present study was performed in 138 epilepsy, who were diagnosed at the Second Hospital of Lanzhou University, Epilepsy Center from February 2008 to February 2010.Those patients were done three examinations including interictal SPECT, V-EEG and imaging studies (MRI/CT). We compared interictal the localization rate of SPECT, V-EEG and CT/MRI.We also compared their consistency in diagnosis on the epileptic foci, comprehensively. Results:In 138 patients, the abnormal rate of interictal SPECT was 86.2%(119/138), of which 57 cases showed focal abnormal in single leaf. V-EEG abnormal rate was 90%(124/138), of which 43 cases (34.7%) showed focal abnormal discharge.69 cases (50%) was abnormal in imaging (CT /MRI),showed local lesions in 48 patients (69.6%).The results of epileptic focus localization by checking the union of three pairwise comparison consistency showed:The The positioning consistent was significant difference between interictal SPECT with V-EEG and with CT/MRI (x2= 7.571, P= 0.006<0.01); in addition, the positioning consistency was also statistically significant between SPECT with CT/MRI and V-EEG with CT/MRI (x2= 7.052, P= 0.008 <0.01). Among them, interictal SPECT with CT/MRI can be consistent in 40.6%of epileptic patients, positioning.Conclusion:SPECT and V-EEG of epileptic patients was significantly higher than imaging studies in the positive rate, but the SPECT with CT/MRI was better in positioning consistency. In particular, the joint mode was a practical and economy to diagnose epileptic foci in patients with clear causes.