Grant-in-Aid for General Scientific Research (C)
|Allocation Type||Single-year Grants |
|Research Institution||Kagoshima University |
ASAKURA Tetsuhiko Kagoshima University, Faculty of Medicine, Professor, 医学部, 教授 (30075254)
TERADA Kousaku Kagoshima Univ., Faculty of Medicine, Assistant professor, 医学部, 助手 (00207482)
KASAMO Sizuya Kagoshima Univ., Faculty of Medicine Univ. Hospital, Assistant professor, 医学部・附属病院, 助手 (60161014)
NIIRO Masaki Kagoshima Univ., Faculty of Medicine Univ. Hospital, Assistant professor, 医学部・附属病院, 助手 (30172612)
KUSUMOTO Kazuhiro Kagoshima Univ., Faculty of Medicine Univ. Hospital, Assistant professor, 医学部・附属病院, 講師 (40145488)
KADOTA Koki Kagoshima Univ., Faculty of Medicine, Subprofessor, 医学部, 助教授 (00094136)
古賀 靖之 鹿児島大学, 医学部附属病院, 助手 (90195701)
妹尾 包人 鹿児島大学, 医学部, 助手 (40163117)
浜田 博文 鹿児島大学, 医学部附属病院, 講師 (80094168)
上津原 甲一 鹿児島大学, 医学部, 助教授 (40094122)
|Project Period (FY)
1987 – 1989
Completed (Fiscal Year 1989)
|Budget Amount *help
¥1,800,000 (Direct Cost: ¥1,800,000)
Fiscal Year 1989: ¥600,000 (Direct Cost: ¥600,000)
Fiscal Year 1988: ¥600,000 (Direct Cost: ¥600,000)
Fiscal Year 1987: ¥600,000 (Direct Cost: ¥600,000)
|Keywords||Epilepsy / Refractory Epilepsy / Surgical Treatment / MRI / MRS / Partial Complex Seizure / Epileptogenic Focus / 外科的治療 / T_2延長 / 海馬萎縮 / 燐代謝低下 / 側頭葉てんかん / 脳波 / X線CT / γCBF / EEG topography / てんかん焦点|
The authors tried to contribute the surgical management on refractory epilepsy through these experiences.
The surgical treatment of epilepsy performed in Japan is almost limited to topectomy and temporal lobectomy. Except for these two methods, sometimes stereotaxic surgery is performed. But transaction, surgical treatment of epilepsy in the real sense of the word, is rarely performed. To decide whether surgical treatment of epilepsy is indicated, preoperative evaluation, whereby the criteria for surgical treatment have to be fully matched, is necessary.
Proper administrative measures are necessary to be taken considering the local financial conditions. The survey shows that the present state is quite unsatisfactory. Therefore at present, these are many important things to be done ranging from the establishment of the operative such as foundation of epileptic centers, spread of information, establishment of a system of co-operative interdisciplinary research.
Magnetic resonance imaging (M
RI) is a newly adopted technique which may be useful in the investigation of epileptogenic lesions, and it became clear that MRI sometimes shows greater sensitivity in the detection of cryptogenic type than X-ray CT does. Our study suggests that MRI contributes the detection of surgically correctable abnormalities in seizure management.
The authors analyzed patients of refractory epilepsy. And we investigated the factors influencing to refractoriness and also surgical indication. Up to the present, patients who had organic lesions as a source of epilepsy tended to be treated surgically. It is noteworthy that there are a few false refractory in the patients without organic lesions. It is important that false refractory patients should be excluded from surgical indications.
MRI is a new approach which may be useful in the investigation of refractory epilepsy for surgical management, further more, 31P-magnetic resonance spectroscopy (MRS) is expected to be a useful method in the investigation of metabolic change in the epileptic focus. 31P-chemical shift imaging (CSI) was done in 11 epileptic patients, and some abnormality was found in 7 cases out of 11 epilepsies. High energy phosphates and inorganic phosphate (Pi) tend to decrease at the side of EEG focus in patients with organic lesions. Less