ABSTRACT
Objective To explore the correlation between the change of regional cerebral blood flow (rCBF) and brain tissue injury from interictal epileptic activity in patients with epilepsy. Methods Fortyeight patients with epilepsy and 30 healthy persons were included in the styudy from which the serum S100β protein levels were determined by double antibody sandwich ELISA method. SPECT rCBF imaging was performed in all patients. The visal and semi-quantitative analyses were used to analyze the epileptic foci.SPSS 11.0 was applied for variance and linear correlation analyses. Results Serum S-100β in patients with interictal epileptic activity was significantly higher than that in control group ((0.572 ± 0. 163) μg/Lvs (0.218 ±0. 134) μg/L, t =9.96, P <0.01). According to epilepsy control criteria, 20 cases achieved complete control (CC), 18 cases acheived partial control (PR). However, 10 cases got no improvement,whose serum S-100β protein ((0. 809 ±0. 056) μg/L) and the percentage change of rCBF ((0. 337 ±0. 060) %) were significantly higher than those of CC ((0.443 ± 0. 083) μg/L, (0.035 ± 0.038) %) and those of PC ((0.585 ±0. 108) μg/L, (0. 187 ±0.075)%), F=56. 740, 92. 316, P <0.01. There were high correlation between serum S-100β and the percentage change of rCBF in epilepsy patients (r =0. 887,P<0.01). Conclusion Serum S-100β protein assay combined with rCBF on SPECT imaging can make semi-quantitative diagnosis of epilepsy and help evaluate the brain damage from interictal epileptic activity.
ABSTRACT
Objective To evaluate the feasibility and clinical value of combined clonidine and sleep-deprivation induced seizures for ictal brain SPECT imaging in patients with epilepsy. Methods Fiftytwo epilepsy patients were given oral clonidine plus sleep-deprivation to induce seizures with video-electroencephalogram (VEEG) monitoring. Forty-seven patients were selected as control group, whose seizures were induced by sleep-deprivation only. 99Tcm-ethylcysteinate dimer (ECD) was injected within 30 s since a clinical sign and/or a typical EEG discharge of epilepsy was recognized. Brain SPECT was performed 30 min after 99TcmECD injection. X2-test was performed by using software SPSS 10. 0. Results One to two hrs after oral intake of clonidine plus sleep-deprivation, 75% (39/52) patients were induced seizures, including 92.3% (36/39) with subclinical seizures and 7.7% (3/39) with clinical seizures. Ictal brain SPECT localized the lesions with high uptake of 99Tcm-ECD in 37 (94.9%) patients. In control group, 38.3% ( 18/47) were induced epileptic seizures, including 77.8% (14/18) with subclinical seizures and 22.2% (4/18) with clinical seizures. The induction rate of epileptic seizures in clonidine plus sleep-deprivation group was significantly higher than that of control group (X2 = 13.614, P ＜ 0.01 ). However, there was no significant difference in clinical seizures between the two groups (X2 = 1.253, P ＞ 0.05 ). Conclusions The combination of oral intake of clonidine and sleep-deprivation could increase the induction rate of epileptic seizures and it is effective for epilepsy SPECT imaging.