Repair of abnormal perfusion foci in idiopathic epilepsy patients under long-term antiepileptic treatment

摘要

Epileptic seizure control and the disappearance of epileptiform discharge are not indicative of the absence of abnormal perfusion foci.Perfusion abnormalities are a major cause of epileptic discharge,and the existence of abnormal perfusion foci implies possible relapse.Very little is known about perfusion abnormality repair in epilepsy.The present study selected 43 cases of idiopathic epilepsy under antiepileptic drug control for an average of 24 months.Comparisons between interictal single-photon emission CT(SPECT)images and long-term electroencephalogram(EEG)pre-and post-treatment showed that cases of normal SPECT increased by 48%(12/25)following treatment,with a total number of 15 reduced foci(36%,15/41).Perfusion foci,i.e.,region of interest,were altered following treatment.These changes included:normal to abnormal in 3 cases(7%,3/43;2 hyperperfusion and 1 hypoperfusion);abnormal to normal in 14 cases(32%,14/43;10 pre-treatment hypoperfusion and 4 hyperperfusion);abnormal to abnormal in 7 cases(16%,7/43;hyperperfusion to hypoperfusion in 5 cases,hypoperfusion to hyperperfusion in 2 cases).Long-term EEG revealed in an increase in the number of normal cases by 20(40%,20/39),and there were 25 fewer cases with epileptiform discharges(66%,25/38).These findings demonstrate that long-term control of anti-epileptic drugs partially repaired cerebral perfusion abnormalities and reduced epileptiform discharges in idiopathic epilepsy.