Neurophysiological and Neuroimaging Assessment of Complex Partial Seizures

[摘要] Background: CPS (complex partial seizures) represents the commonest type of refractory epilepsy and proper management of such seizures necessitates proper localization of the seizure focus. The techniques of EEG (electroencephalography) remain the principal investigation for localizing seizure foci . When clinical features and EEG are not localizing and structural neuroimaging studies are normal, functional imaging will be of great value. Objective: To specify the sensitivity of EEG as a localizing & lateralizing tool in the diagnosis of CPS and to compare the EEG findings with imaging studies. Methods: The study was conducted on 30 patients (13 males and 17 females) with CPS. Patients were assessed by clinical examination, interictal video EEG monitoring, brain MRI (Magnetic Resonance Imaging) study and interictal SPECT (Single Photon Emission Computed Tomography). Results: The localizing sensitivity of interictal EEG was 100%. The lateralizing sensitivity was 83.3%.The localizing and lateralizing sensitivity of MRI were both 30%. Qualitative SPECT had localizing and lateralizing sensitivities of 83.3% and 80.7% respectively. Quantitative SPECT had localizing and lateralizing sensitivities of 80% and 76% respectively. When EEG and SPECT findings were combined together, the lateralizing sensitivity was 100%. Conclusion: EEG is still the principal investigating tool for localizing seizure foci and confirming the site suggested by clinical features and SPECT is a useful diagnostic tool, especially when combined with EEG. (Egypt J Neurol Psychiat Neurosurg. 2010; 47(1): 99-106)

[学科分类] 精神健康和精神病学