側頭葉てんかんの近赤外線モニターによる脳内酸素変動と血流動態  [in Japanese] Changes of Cerebral Blood and Tissue Oxygenation in Temporal Lobe Epilepsy Shown by Near Infrared Spectroscopy  [in Japanese]

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Abstract

近赤外線を利用して脳組織内の酸素変動を無侵襲かつ容易に脳波室で検査可能となった。近赤外線モニターは、新生児、意識障害の患者、ICUの重症患者、モヤモヤ病などの脳全体の組織内酸素変動に応用されてきたが、側頭葉てんかんの局在性の酸素変動に関する臨床研究は十分行われていない。今回、側頭葉に形態の異常を示した症候性部分てんかん11症例にハママツホトニクス社のNIRSを使用して、脳波記録中3分の過呼吸負荷を行いつつ、最初に左側頭前部と中部に光ファイバー入出力光のダイオードを装着し負荷後も記録を行い、次に右側頭中部と前部で実施した。その結果、萎縮を示した側頭葉で過呼吸負荷時に酸化型ヘモグロビン (HbO<SUB>2</SUB>) が9症例で減少し、他の2例の側頭葉切除例ではHbO<SUB>2</SUB>の変動は切除側でみられず、反対側では酸素変動が大きかった。しかし、還元型ヘモグロビン (HbR) は萎縮側と反対側では相違を示さなかった。さらに、近赤外線モニターによる局在性側頭葉機能検査の臨床応用について研究を重ねる必要がある。

Near infrared spectroscopy (NIRS) appears to be a safe, noninvasive technique useful in the EEG laboratory.NIRS has been used for continuous monitoring of changes in blood and tissue oxygenation of the whole brain. We report our observa-tions of changes in local cerebral oxygenation in temporal lobe epilepsy.<BR>Eleven patients (four men, seven women;average age31.9years) including two patients after surgical treatment were selected by identifing temporal lobe atrophy and lateralizing the epileptic focus, by means of MRI, SPECT and EEG. Using NIRS (Hamamatsu Photonics Co., Hamamatsu, Shizuoka, Japan), changes in cerebral blood and tissue of oxygenated haemoglobin (HbO<SUB>2</SUB>) and deoxygenated haemoglobin (HbR) produced by hyperventilation (HV) were measured in both the temporal region with the atrophy and the contralateral temporal region.<BR>In both temporal regions, HbO<SUB>2</SUB>values decreased from baseline (at start of HV) after the end of HV, but there was no difference between temporal region with atrophy and contralateral temporal region. However, in nine cases except two cases after surgical treatment, there was difference between them when HV ended.HbR values changed from baseline, but there was no difference between temporal region and contralateral region. Because of results, it is suggested that NIRS may be useful for one of supplementary diagnosis of temporal lobe epilepsy, but it is necessary to investigate further.

Journal

  • Journal of the Japan Epilepsy Society

    Journal of the Japan Epilepsy Society 16(2), 109-116, 1998-06-30

    JAPAN EPILEPSY SOCIETY

References:  19

Cited by:  1

Codes

  • NII Article ID (NAID)
    10008555976
  • 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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