| Objective:To explore the characteristics of clinical symptoms,MRI,interictal SPECT,and video-EEG in epilepsy patients with abnormality of brain structure,and the relation of MRI and interictal SPECT, interictal SPECT and V-EEG, Further studies of the contact between Pathological lesions and Epileptic foci.Methods:From February2013to February2014, outpatient and inpatient diagnosed as epilepsy according to the standards established in the Second Hospital of Lanzhou University, Epilepsy Center. Collecting113cases of brain MRI showed a clear structural abnormalities in patients with epilepsy. We record the general condition,such as gender, name, age, duration, past medical history, MRI image and so on, determine seizure type and checking interictal SPECT and V-EEG. Analyzing the results of MRI, interictal SPECT and V-EEG findings by SPSS17.0statistical software.Results:113cases epilepsy patients with abnormality of brain structure,76men,37women, aged2to67years (median age22years),28cases less than the12-year-old,18cases between13years and18years,61cases between18years and60years,6cases more than60years; course of disease one week to36years (median6years).54cases Unknown cause of disease,59cases have a clear cause of disease,including10cases perinatal abnormalities,of which3cases premature birth,4cases intracranial hemorrhage after birth,1case asphyxia,2cases neonatal hypoxic ischemic history.17cases head trauma,15cases infections diseases of the central nervous system,6cases febrile seizures,6cases brain surgery and5cases others, including2cases of febrile seizures+premature birth,1case of febrile seizures dystocia+head trauma,1case of febrile seizures+head trauma,1case of head injury in preterm+heat convulsions.14species abnormal MRI findings including brain atrophy in28cases (24.78%), softening of the brain35cases (30.97%), cerebral dysplasia19cases (16.82%), brain malformation3cases (2.65%),28cases others(24.78%), Including2cases abnormal signal (vascular malformations),1case Verga cyst cavity,brain atrophy+softening of the brain in5cases,1case tuberous sclerosis,3cases abnormal neuronal migration, abnormal signals (demyelination) in8cases,2cases bilateral globus pallidus in the left temporal pole arachnoid cyst, caudate3cases nucleus abnormal signals,1case the left choroid cyst,1case of cerebral cysticercosis change under multiple subdural hemorrhage. Types of seizures:108cases one kind of attack forms, generalized seizures75cases (66.37%), partial seizures in38cases (33.63%),2cases showed two kinds of seizures,3cases showed three kinds of seizures. MRI showed structural abnormalities, single lesion in22cases,62cases multifocal lesions, in the right hemisphere in13cases, whole brain structural abnormalities in16cases. Interictal SPECT imaging was normal in22cases,91cases of abnormal (80.53%),including a single abnormal perfusion foci in30cases,46cases more than one abnormal perfusion foci,10cases the side of the hemisphere,whole brain5cases,low perfusion foci in84cases,high perfusion foci in7cases,0case low-high perfusion foci.V-EEG in36cases is normal,77cases is abnormal (68.14%), mild abnormalities in5cases,72cases epileptiform discharges, focal epileptic discharge in abnormal discharge55cases,17cases generalized abnormal discharge. The relation Between MRI lesions abnormal and SPECT perfusion abnormalities is that24cases (21%) are consistent (44%),49cases unanimously,40cases (35%) completely unrelated. For brain structural abnormalities in patients, the positive rate of SPECT is higher than V-EEG.Conclusions:Brain atrophy, softening of the brain in Structural abnormalities is more common, and the MRI showed multiple lesions.head trauma, central nervous system infection is more common.many types of seizures in patients with epilepsy showed generalized tonic clonic seizures, EEG abnormalities of most patients showed partial discharge, which may be associated with the parts of structural abnormalities of the brain and causes of disease.The relation Between MRI lesions abnormal and SPECT perfusion abnormalities is that24cases (21%) are consistent (44%),49cases unanimously,40cases (35%) completely unrelated.but most patients (29%) are the number of abnormal perfusion foci than the number of structural abnormalities of the brain lesions, the positive rate of SPECT is higher than V-EEQ so combination of both is important, especially in the surgical treatment of epilepsy surgery. The results for the diagnosis and prevention of epilepsy have an important role in promoting the study of epileptic foci and pathological lesions, and lay the theoretical foundation for the future of epileptogenic foci... |
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