NAKAMURA Katsumi Kagoshima Univ., Faculty of Medicine, Research Associates, 医学部, 助手 (60180361)
NIIRO Masaki Kagoshima Univ., Faculty of Medicine, Research Associates, 医学部, 助手 (30172612)
KUSUMOTO Kazuhiro Kagoshima Univ., Faculty of Medicine, Assistant Professor, 医学部, 講師 (40145488)
KADOTA Koki Kagoshima Univ., Faculty of Medicine, Associate Professor, 医学部, 助教授 (00094136)
|Budget Amount *help
¥2,400,000 (Direct Cost : ¥2,400,000)
Fiscal Year 1992 : ¥800,000 (Direct Cost : ¥800,000)
Fiscal Year 1991 : ¥900,000 (Direct Cost : ¥900,000)
Fiscal Year 1990 : ¥700,000 (Direct Cost : ¥700,000)
(1) The authors are now reporting the results of the investigation with questionnaire to the official training institutes designated by the Japan Neurosurgical Society in 1987 and 1992.1)Surgical treatment of refractory epilepsy is performed in 29 institutes, about 50 cases in 1987, and 34 institutes, about 120 cases, 1991.2) In 1987, the operative methods performed in these cases are topectomy, temporal lobectomy, and stereotaxic surgery. In 1991, those are topectomy, temporal lobectomy and callosotomy. 3) In 1987, Totally, about 50 surgical treatment of epilepsy are performed in a year.
(2) The criteria for surgical treatment on the refractory epilepsy is necessary. The guideline of the surgical treatment of refractory epilepsy were discussed on the surgical indication (selection of patients), protocol, pre- and post-operative evaluation and operative outcome. We were reporting the results of the DRAFT on the guideline.
(3) In this study we examined 100 patients with epilepsy. MR image
s have shown various findings in 100 patients with epilepsy. MR revealed 48 lesions in 42 patients. The location of the 48 lesions were 26 in temporal, 4 in occipital, 6 in lateral ventricle, and 3 and 7 in frontal and parietal.
(4) The authors have investigated cerebral metabolism in the epileptic patients with ^<31>P MRS in addition to conventional MRI. 31P-chemical shift imaging(CSI)was acquired by with SIDAC and 3DFT. The subjects comprised 16 males and 11 females aged 9 to 62 years. 17 patients had partial seizures and 10 had generalized seizures. EEG revealed focal abnormalities in 17 of 27 patients. The authors compared the distribution of total phosphate, ATP, PCr, PDE, Pi and PME between cerebral hemisphere with the lesions and contralateral hemisphere. A Siemens-Asahi Super 200 MRI was employed. ^<31>P-CSI detected abnormalities in 21 out of 27 patients and 17 of them had partial seizures. In patients with apparent organic lesions, the signals of PCr, ATP and Pi were lower in the lesional hemisphere than in the contralateral hemisphere. These changes in phosphates levels seem suggest that energy metabolism was reduced in the brain regions around the seizures foci during the interictal stage. Thus, CSI appeared to be effective for diagnosing the epileptic foci in patients with refractory epilepsies. Less