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【Epilepsy】PET可以检测到EEG无痫样放电的表现为失语和遗忘的癫痫状态

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Aphasic or amnesic status epilepticus detected on PET but not EEG
KEYWORDS
Positron emission tomography • Status epilepticus • Aphasic status epilepticus • Aphasia • Amnesia
ABSTRACT
Purpose: To describe five patients with ictal aphasia and one patient with ictal amnesia, who had focal positron emission tomography (PET) hypermetabolism but no clear ictal activity on electroencephalography (EEG).

Methods: 18F-Fluorodeoxyglucose (FDG)–PET scans with concomitant EEG were obtained in five patients with suspected ictal aphasia or ictal amnesia without ictal activity on EEG. We reviewed medical history, EEG, imaging data, and treatment outcome.

Results: Brain magnetic resonance imaging (MRI) showed no structural abnormalities in any of the patients. EEG showed left temporal irregular delta activity in three patients, with aphasia and nonspecific abnormalities in two other patients, all without clear ictal pattern. All patients demonstrated focal hypermetabolism on PET scan. The hypermetabolism was in the left frontotemporal region in patients with ictal aphasia and in the bilateral hippocampal region in the patient with amnesia. Three patients who received intravenous benzodiazepines during their episodes had transient clinical improvement. With antiepileptic drug (AED) treatment, symptoms gradually resolved in all patients. Concomitant resolution of PET hypermetabolism was documented in three patients who had follow up scans. One patient with ictal aphasia later developed recurrent episodes, each with recurrent PET hypermetabolism. This patient and one other patient required immune-modulating therapy in addition to AEDs.

Discussion: FDG-PET imaging should be considered as a diagnostic tool in patients with suspected ictal aphasia or amnesia, who fail to show clear evidence of ictal activity on EEG.
http://www3.interscience.wiley.com/journal/121411891/abstract

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2008-10-21 23:26 浏览 : 1100 回复 : 4

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limin0214

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2008-11-18 00:28

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limin0214

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Aphasic or amnesic status epilepticus detected on PET but not EEG
失语症或记忆丧失癫痫持续状态检测对PET而非脑电图的检测
1.Purpose: To describe five patients with ictal aphasia and one patient with ictal amnesia, who had focal positron emission tomography (PET) hypermetabolism but no clear ictal activity on electroencephalography (EEG).
目的：描述5例发作性失语和1例发作性失忆症，他们之前做过的局部正电子发射断层扫描技术（ PET ）高代谢，但脑电图（EEG）没有明显的发作活动.
2.Methods: 18F-Fluorodeoxyglucose (FDG)–PET scans with concomitant EEG were obtained in five patients with suspected ictal aphasia or ictal amnesia without ictal activity on EEG. We reviewed medical history, EEG, imaging data, and treatment outcome.
方法：5名患者进行18氟脱氧葡萄糖PET扫描的同时记录脑电图，这5例疑似失语症或失忆症发作而无发作的脑电活动。我们回顾病史，脑电图，影像数据，以及处理结果。
3.Results: Brain magnetic resonance imaging (MRI) showed no structural abnormalities in any of the patients.
结果：脑MRI显示没有结构的任何异常的患者。
4.EEG showed left temporal irregular delta activity in three patients, with aphasia and nonspecific abnormalities in two other patients, all without clear ictal pattern.
脑电图显示，3个病人左颞不规则δ波，另外两个病人出现失语和非特异性异常，而他们都没有明确的发作模式。
5.All patients demonstrated focal hypermetabolism on PET scan.
所有患者PET扫瞄表现出局部高代谢。
6.The hypermetabolism was in the left frontotemporal region in patients with ictal aphasia and in the bilateral hippocampal region in the patient with amnesia.
发作性失语患者高代谢区位于左额颞叶区，失忆症患者高代谢区位于双侧海马区。
7.Three patients who received intravenous benzodiazepines during their episodes had transient clinical improvement.
三名病人在发作期间接受静脉注射苯二氮卓类药物后发生了临床改善。
8.With antiepileptic drug (AED) treatment, symptoms gradually resolved in all patients.
在抗癫痫药物（ AED ）的治疗后，所有患者的症状逐步缓解。
9.Concomitant resolution of PET hypermetabolism was documented in three patients who had follow up scans.
三名病人随访做PET后高代谢消退也被记录下来。
10.One patient with ictal aphasia later developed recurrent episodes, each with recurrent PET hypermetabolism.
1例发作性失语患者后来反复癫痫发作，每次都伴随PET扫描高代谢。
11.This patient and one other patient required immune-modulating therapy in addition to AEDs.
这病人和另外一名病人除了抗癫痫药物还需要免疫调节治疗。
12.Discussion: FDG-PET imaging should be considered as a diagnostic tool in patients with suspected ictal aphasia or amnesia, who fail to show clear evidence of ictal activity on EEG.
讨论：对于涉嫌发作性失语或失忆症，而没有显示明确脑电活动证据的患者，
氟脱氧葡萄糖PET显像应被看作是一个诊断工具。

2008-11-18 13:32

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limin0214 编辑于 2008-11-18 23:55

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limin0214

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编译

题目：失语症或记忆丧失癫痫持续状态检测对PET而非脑电图的检测
目的：描述5例发作性失语和1例发作性失忆症，他们之前做过的局部正电子发射断层扫描技术（ PET ）高代谢，但脑电图（EEG）没有明显的发作活动.
方法：5名患者进行18氟脱氧葡萄糖PET扫描的同时记录脑电图，这5例疑似失语症或失忆症发作而无发作的脑电活动。我们回顾病史，脑电图，影像数据，以及处理结果。
结果：脑MRI显示没有结构的任何异常的患者。脑电图显示，3个病人左颞不规则δ波，另外两个病人出现失语和非特异性异常，而他们都没有明确的发作模式。所有患者PET扫瞄表现出局部高代谢。发作性失语患者高代谢区位于左额颞叶区，失忆症患者高代谢区位于双侧海马区。三名病人在发作期间接受静脉注射苯二氮卓类药物后发生了临床改善。在抗癫痫药物（ AED ）的治疗后，所有患者的症状逐步缓解。三名病人随访做PET后高代谢消退也被记录下来。1例发作性失语患者后来反复癫痫发作，每次都伴随PET扫描高代谢。这病人和另外一名病人除了抗癫痫药物还需要免疫调节治疗。
讨论：对于涉嫌发作性失语或失忆症，而没有显示明确脑电活动证据的患者，
氟脱氧葡萄糖PET显像应被看作是一个诊断工具。

2008-11-18 23:58

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