Tomografia por emissão de fóton único em epilepsia temporal: estudos intercríticos e críticos com análise visual e semi quantitativa Single photon emission tomography in temporal lobe epilepsy: visual and semi quantitative analysis in interictal and ictal studies

• Main Authors: Elza Márcia T. Yacubian, Lilian Y.I. Yamaga, Rosa Maria F. Valério, Lia A. Fiore, Carmen Lisa Jorge, Carlos A. Buchpiguel
• Format: Article
• Language: English
• Published: Academia Brasileira de Neurologia (ABNEURO) 1995-09-01
• Series: Arquivos de Neuro-Psiquiatria
• Subjects: epilepsia; epilepsia temporal; SPECT; epilepsy; temporal lobe epilepsy
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X1995000300002
• ISSN: 0004-282X; 1678-4227

Vinte e oito estudos intercríticos e 9 críticos/pós críticos de tomografia por emissão de fóton único (SPECT) foram realizados em 27 pacientes com epilepsia do lobo temporal e esclerose mesial temporal. Estudos intercríticos localizaram corretamente a área epileptogênica em 19 (67%) dos pacientes pela análise visual e 16 (61,5%) pela semi quantitativa, com 10,7 e 15,3%, de falsa lateralização respectivamente. Todos os 9 estudos críticos/ pós críticos detectaram o hemisfério epileptogênico e permitiram localização correta da área epileptogênica em 5 de 9 pacientes cujos exames intercríticos haviam sido inconclusivos. Três estudos realizados durante crises secundariamente generalizadas e simétricas mostraram hiperfluxo restrito ao lobo temporal.<br>Single photon emission tomography (SPECT) was performed in 27 patients with refractory complex partial seizures from the temporal lobes due to mesial temporal sclerosis. Independent blinded observers assessed the 28 interictal studies and 9 ictal/postictal studies. Visual analysis of interictal studies detected hypoperfusion in 22, ipsilateral to the epileptogenic zone in 19 (67%) and contralateral in 3 (10.7%). Quantified temporal lobe asymmetry, greater than a previously derived normal range, correctly identified the epileptogenic zone in 16 (61.5%) with false lateralization in 4 (15.3%). In all 9 cases in which they were performed, ictal/postictal studies showed hypoperfusion at the region of epileptic focus. In 3 patients with complex partial seizures followed by symmetric generalized tonic-clonic seizures, hyperperfusion restricted to the temporal lobe was demonstrated. In 5 of these patients the interictal studies were unable to demonstrate localized changes. There were no significant correlations between SPECT findings and clinical parameters or EEG slowing in the temporal lobes.