The role of quantitative ictal SPECT analysis in the evaluation of nonepileptic seizures.
The role of quantitative ictal SPECT analysis in the evaluation of nonepileptic seizures.
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定量发作 SPECT 分析在评估非癫痫发作中的作用。
DOI：
10.1111/jon199994210
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发表时间：
1999
期刊：
影响因子：
--
通讯作者：
Zubal,IG
中科院分区：
文献类型：
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作者：
Spanaki,MV;Spencer,SS;Corsi,M;MacMullan,J;Seibyl,J;Zubal,IG
非癫痫发作可能是难以诊断的问题。确定它们的存在和频率对于确定适当的治疗至关重要。作者研究了发作期单光子发射断层扫描(SPECT)差值图像定量血流灌注变化在鉴别非癫痫和癫痫发作中的价值。对11例临床怀疑为非癫痫事件的患者进行了发作期和发作期99m六甲基丙烯胺SPECT扫描，同时进行了连续的视听脑电监测。作者分析了基于发作期和发作期SPECT图像的配准、归一化、ANCI减影的灌注差值图像。不同的图像被配准到每个患者的磁共振成像扫描中，以解剖地定位发作期的血流灌注变化。11名患者中有3名也被诊断为癫痫，并正在服用抗癫痫药物。五名患者正在服用抗癫痫药物，但癫痫的诊断尚未得到证实。在所有患者中，连续的视频脑电监测显示没有发作期的脑电表现。在其中9例患者中，发作期SPECT的视觉解释提示局部血流灌注增加(n=6)或减少(n=3)。然而，在所有患者中，在癫痫样事件期间进行注射的SPECT定量分析中没有发现血流变化，这表明诊断为假性癫痫。作者的结果表明，发作期SPECT定量分析是诊断非癫痫发作的有用工具。
Nonepileptic seizures may represent difficult diagnostic problems. Identifying their presence and frequency is critical for determining appropriate treatment. The authors investigated the value of quantitative perfusion changes as measured by ictal single‐photon emission tomography (SPECT) difference images in differentiating nonepileptic from epileptic seizures. Eleven patients with a clinical suspicion of nonepileptic events had ictal and interictal technetium‐99m hexamethylpropylene amine SPECT scans during continuous audiovisual surface electroencephalogram (EEG) monitoring. The authors analyzed perfusion difference images based on registration, normalization, anci subtraction of ictal and interictal SPECT images. The difference images were registered to each patient's magnetic resonance imaging scan to anatomically localize ictal perfusion changes. Three of 11 patients also carried the diagnosis of epilepsy and were taking antiepileptic medication. Five patients were taking antiepileptic drugs, but the diagnosis of epilepsy was not confirmed. In all patients, continuous video EEG monitoring revealed no ictal EEG findings. In nine of these patients, visual interpretation of ictal SPECT was suggestive of localized increased (n= 6) or decreased perfusion (n= 3). In all patients, however, no blood flow changes were noted on quantitative SPECT analysis with injections performed during the seizure‐like event, suggesting the diagnosis of pseudoseizures. The authors' results suggest that quantitative ictal SPECT analysis is a useful tool in the diagnosis of nonepileptic seizures.