論文

査読有り 国際誌
2020年2月16日

Visualizing prolonged hyperperfusion in post-stroke epilepsy using postictal subtraction SPECT.

Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism
  • Kazuki Fukuma
  • ,
  • Katsufumi Kajimoto
  • ,
  • Tomotaka Tanaka
  • ,
  • Shigetoshi Takaya
  • ,
  • Katsuya Kobayashi
  • ,
  • Akihiro Shimotake
  • ,
  • Riki Matsumoto
  • ,
  • Akio Ikeda
  • ,
  • Kazunori Toyoda
  • ,
  • Masafumi Ihara

41
1
開始ページ
271678X20902742
終了ページ
156
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1177/0271678X20902742

Diagnosis of post-stroke epilepsy is often challenging because of a low incidence of epileptiform abnormalities on electroencephalography (EEG). Hence, this study evaluated whether postictal subtraction single-photon emission computed tomography (SPECT) could visualize epileptic activity and act as a diagnostic modality in post-stroke epilepsy. Fifty post-stroke epilepsy patients, who had undergone Tc-99m-ECD SPECT twice (postictal and interictal), were enrolled. The postictal hyperperfusion area was identified by subtraction (postictal-interictal) SPECT and classified into two distribution types: superficial or deep-seated. Laterality and distribution of postictal hyperperfusion on subtraction SPECT were compared with stroke lesions, seizure symptoms, and epileptiform EEG findings. Forty-three of the 50 patients (86%) had hyperperfusion on subtraction SPECT and 26 (52%) had epileptiform EEG findings. Subtraction SPECT showed prolonged postictal hyperperfusion despite the relatively long interval between seizure end and postictal SPECT (median: 19.1 h, range: 2.2-112.5 h). The laterality of the hyperperfusion area had a high concordance rate with the laterality of stroke lesions (97.7%), seizure symptoms (91.9%), and epileptiform EEG findings (100%). Scalp EEG identified epileptiform activity more frequently in superficial type of SPECT, but less frequently in deep-seated type (both, P = 0.03). Postictal SPECT can be complementary to scalp EEG in endorsing the diagnosis and location of post-stroke epilepsy.

リンク情報
DOI
https://doi.org/10.1177/0271678X20902742
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/32065077
PubMed Central
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7747161
ID情報
  • DOI : 10.1177/0271678X20902742
  • PubMed ID : 32065077
  • PubMed Central 記事ID : PMC7747161

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