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Yıl:1994; Cilt: 31; Sayı: 4>> Özet
Nöropsikiyatri Arşivi; 1994;31(4):193-205
Temporal Lob Epilepsisi ve Jeneralize İdyopatik Epilepsi Olgularında Tc99-M-HMPAO SPECT İle Görüntüleme
BB Kurt, S Ünal, A Gökyiğit, A Mudun, R Tuncay, S Cantez, A Çalışkan
İstanbul Tıp Fakültesi, Nöroloji Anabilim Dalı\r\n
SPECT incelemesinin epilepsideki değerini araştırmak amacıyla 27 epilepsi olgusunda interiktal dönemde Tc99m-HMPAO SPECT incelemesi yapılmış ve sonuçlan klinik özellikler, yûzeyel EEG ve MRG/BT verileri ile karşüaştınlmıştır. Klinik ve/veya EEG kriterlerine göre, temporal lob epilepsisi tanısını almış olan 20 olgu birinci grup olarak adlandırılırken, idyopatik jeneralize epilepsisi olan 7 olgu ikinci grubu oluşturmuştur. Birinci grupta SPECT ile % 70 oranında hipoperfüzyon gösterilmiştir. Bu oran MRG/BT (% 47) ve EEG (% 50) incelemelerinin lokalize bulgu verme oranlarından yüksektir. EEG ve MRG incelemelerinin SPECT ile % 55 oranında uyum gösterdikleri saptanmıştır. Yüzeyel EEG'nin normal olduğu veya patolojik bölgeyi lokalize edemediği 4 olguda SPECT ile hipoperfüze alan gösterilmiş, buna karşın SPECTin normal sınırlarda kaldığı 3 olguda EEG ile lokalize bulgu saptanabilmiştir. Bir olgu için ise EEG ve SPECT tümüyle farklı bölgeleri patolojik olarak göstermiştir. SPECT ile 7 olguda birden çok bölgede perfüzyon defekti gözlenmiştir. Patolojik bulgu verme açısından SPECT ile diğer yöntemler arasında istatistiksel olarak anlamlı bir ilişki gösterilememiştir. Sonuç olarak SPECT temporal lob epilepsisinde tek başına bir tanı aracı değildir, ancak diğer yöntemlerle birlikte kullanıldığında kortikal odağın belirlenmesinde yardımcı olabildiği sonucuna varılmıştır.
İkinci grupta yer alan 7 olgunun tümünde interiktal SPECT ve ayrıca 2 olguda iktal
Tc99m-HMPAO SPECT Imaging In Temporal Lobe Epilepsy and Generalized Idiopathic Epilepsy
In order to investigate the value of SPECT study in epilepsy Tc99m-HMPAO SPECT imaging was performed during interictal stage in 27 epileptic patients and the results were compared with clinical features, scalp EEG and MRI/CT data. Twenty patients with temporal lobe epilepsy, diagnosed according to clinical and/or EEG criteria, were called group 1, while 7 patients with generalized idiopathic epilepsy were called group 2.
In the first group SPECT imaging showed 70 % local hypoperfusion. This local abnormality rate shown by SPECT was superior to that of MRI/CT (47%) and EEG (50%). The concordance between SPECT and MRI, and SPECT and EEG were both 55 %. In 4 cases with normal or nonlocalizing EEG findings, SPECT could demonstrate one or more localized areas of hypoperfussion. In contrast, in 3 patients with prominent EEG foci, SPECT investigations were interpreted as normal. In one patient the findings of EEG and SPECT demonstrated entirely different areas. Multifocal perfusion defects were found in 6 cases. Statistical analysis did not show a significant correlation between the existence of pathological findings in other investigation methods and SPECT data. As a result. SPECT does not seem to be a primary diagnostic tool in temporal lobe epilepsy, but when used in conjunction with clinical data and other laboratory methods, it

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