Diagnostic methods for extra-temporal neocortical focal epilepsies: present and future

Arquivos de Neuro-Psiquiatria

Ricardo André Amorim Leite²  Maria Concépcion Garcia Otaduy¹  Gilson Edmar Gonçalves E Silva¹  Maria Lúcia Brito Ferreira²  Maria De Fátima Vasco Aragão¹ 

[1] ,Hospital da Restauração Neurology Department Epilepsy and Neurophysiology CenterRecife PE ,Brazil

关键词: extratemporal neocortical epilepsies;    diagnostic methods;    magnetic resonance spectroscopy;    pre-surgical evaluation;    epilepsias neocorticais extratemporais;    métodos diagnósticos;    espectroscopia por ressonância magnética;    avaliação pré-cirúrgica;   

DOI  :  10.1590/S0004-282X2010000100025

来源: SciELO

【 摘 要 】

The progress of epilepsies diagnosis has been great, but, amongst the diagnostic detailing that demand research, one of the most important is the essential lateralization and localization of epileptogenic zone, considered as the cerebral cortex region, that removed, will result in a free state of seizures. The present study aims to analyze the possible uses of proton spectroscopy for clinical and pre-surgical evaluation of focal extratemporal epilepsies, since this group presents the highest difficulty degree for lateralizing and locating epileptogenic zones. In almost all cases, a non invasive diagnosis can be performed using routine electroencephalography, video-electroencephalography - considered as gold standard, and magnetic resonance imaging. However, when the results of these exams are contradictory, some patients need invasive techniques, as the intra-cranial video-EEG, using deep electrodes, sub-dural strip and grid, that are associated with increased diagnostic cost and risk of complications, as cerebral hemorrhages and intra-cranial infections. Proton spectroscopy appears as a possibility, given its capacity to evaluate cerebral metabolism, by N-acetyl-aspartate (NAA), creatine (Cre) and choline (Cho) concentrations, amongst other metabolites. This non invasive method may provide time reduction of this evaluation and reliable level improvement for this topographical diagnosis.

【 授权许可】

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