| 측두엽간질에서 와다 기억력과 간질 초점의편측화에 대한 FDG-PET의 예측력 |
| 홍승봉, 노숙영*이강연욱† 김후원이신원철이서대원이김상은‡ |
| "성균관대학교 의과대학 삼성서울병원 신경과,핵의학과‡,분당제생병원 신경과*,한림대학교 심리학과†" |
| The Predictive Value of FDG-PET for Lateralizing Wada Memory Dominance and Epileptic Focus in Patients with Temporal Lobe Epilepsy |
| Seung Bong Hong, M.D., Suk Young Roh, M.D.*, Yeonwook Kang, Ph.D.†, Hoowon Kim, M.D.,Won Chul Shin, M.D., Dae Won Seo, M.D., Sang Eun Kim, M.D.‡ |
| Departments of Neurology, and Nuclear Medicine‡,Sungkyunkwan University School of Medicine, Seoul, KoreaDepartment of Neurology, Pundang Jesaeng General Hospital, Seoul, Korea*Department of Psychology, Hallym University, Chunchon, Korea† |
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| Abstract |
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Backgroud : To examine the predictability of regional cerebral glucose metabolism in determining Wada memory dominance and lateralizing epileptic focus. Methods : 1 8 F-fluorodeoxyglucose positron emission tomography (FDG-PET) and Wada test were performed in 18 patients with temporal lobe epilepsy (TLE). Regions of interest were deter-mined in mesial, polar, anterior-lateral, mid-lateral, and posterior-lateral regions of the temporal lobe. The asymmetry indices of FDG-PET (PET-AI) were calculated in each ROI of temporal lobe, and those of Wada memory test (Wada-AI) were obtained as well. Results : Pearson correlation coefficient showed Wada-AI was significantly correlated with PET-AI in mesial (r=0.67, p=0.001), polar (r=0.55, p=0.010), anterior-lateral (0.55, p=0.009) and mid-lateral (r=0.51, p=0.016) temporal regions. However, after simple linear regression analysis, PET-AI of mesial temporal region alone was significantly correlated with Wada-AI (p=0.008). In localizing epileptic focus, Wada-AI could correctly lateralize the seizure focus in 90% of the left TLE and 75% of the right TLE patients. No false lateralization by Wada-AI was observed except two patients showing prolonged confusion after amobarbital injection who were not included in this study. The PET-AI of the mesial temporal region showed the highest sensitivity of seizure lateralization (100% of left TLE and 87.5% of right RLE). Conclusions : Although FDG-PET hypometabolism is observed both at mesial and lat-eral regions of the temporal lobe in mesial TLE, mesial temporal region appeared to be a dominant and leading area for lateralizing Wada memory dominance and epileptic focus.J Korean Neurol Assoc 18(6):700~705, 2000Key Words : FDG-PET, Cerebral glucose metabolism, Wada memory test, Asymmetry index, Temporal lobe epilepsy |
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