側頭葉てんかんのプロトン磁気共鳴スペクトロスコピーによる研究  [in Japanese] Study of Temporal Lobe Epilepsy Using ^1H Magnetic Resonance Spectroscopy  [in Japanese]

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Abstract

長期にわたって通院加療中で、脳波上側頭部に焦点性の一・側性放電を示す側頭葉てんかん患者10名の発作問欠期の1H磁気共鳴スペクトロスコピー (MRS) 検査を行った。ニューロンの器質的及び機能損傷を反映するNAA (N-acetylaspartate) /Cr (creatineとphosphocreatine) 比は、全員脳波上のてんかん焦点と同側の側頭葉内側部で低下した。焦点側のみならず反対側の側頭葉内側部でも、NAA/Cr比の低下、または低下傾向が10名中6名に認められた。NAAレベルの低下が左側のてんかん焦点および反対側側頭葉内側部の両側にある群は、その他の群に比べて発作の形態が複雑であり、抗てんかん薬でのコントロールが困難な傾向があり、種々の心理的障害のため社会的適応が困難で、予後が不良であった。NAAレベルの両側性の低下は側頭葉てんかんの臨床症状、経過、予後と関係がある。

Ten long-term outpatients having temporal lobe epilepsy and unilateral epileptic focus in scalp EEG were studied in interictal periods using1H magnetic resonance spectroscopy (MRS). The N-acetylaspartate (NAA)/creatine plus phosphocreatine (Cr) ratio in the mesial temporal region ipsilateral to the epileptic focus was signifi-cantly decreased in patients, compared to that of control subjects, which reflected neuronal loss or neuronal dysfunction. NAA/Cr ratios were also decreased in the temporal region contralateral to the epileptic focus in 6 out of 10 patients, although less than those in the ipsilateral region. The group with decreased levels of NAA in only the right epileptic focus showed less severity of symptoms related with temporal lobe epilepsy, such as complicated seizure pattern, efficacy of antiepileptic drugs, psycho-logical disturbances, social adaptation and prognosis, than groups with a bilateral decreases in NAA levels. These symptoms were particularly worse in the group with left EEG focus and NAA levels that were decreased not only in the left mesial temporal region ipsilateral to the epileptic focus but also in the contralateral temporal region. H MRS study demonstrated that laterality and bilateral decrease in NAA/Cr ratios have a close relation with clinical symptoms, course and prognosis in temporal lobe epilepsy.

Journal

  • Journal of the Japan Epilepsy Society

    Journal of the Japan Epilepsy Society 15(3), 178-188, 1997-10-31

    JAPAN EPILEPSY SOCIETY

References:  31

Cited by:  1

Codes

  • NII Article ID (NAID)
    10008555824
  • NII NACSIS-CAT ID (NCID)
    AN10043823
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    09120890
  • Data Source
    CJP  CJPref  J-STAGE 
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