癫痫是最常见的神经系统疾病之一,估计全世界患病率超过5000万人,年发病率为200万人。虽然药物治疗与抗癫痫药物(ASM)是治疗的选择,约30%的癫痫患者对ASM无反应并耐药。局灶性癫痫是最常见的癫痫形式。在耐药局灶性癫痫患者中,癫痫手术是一种治疗选择,取决于癫痫发作重点的定位,以缓解癫痫发作或癫痫发作自由,并连续改善生活质量。除了头皮视频/脑电图(EEG)遥测等检查,结构,和功能磁共振成像(MRI),这是癫痫患者的诊断工作和治疗管理的主要标准工具,使用单光子发射计算机断层扫描(SPECT)和正电子发射断层扫描(PET)的不同放射性药物的分子神经成像对治疗决策的影响和影响。迄今为止,对于在癫痫中使用核医学(NM)成像程序,没有基于文献的实践建议.这些指南的目的是帮助理解癫痫放射性示踪剂成像的作用和挑战;提供用于执行癫痫的不同分子成像程序的实用信息;并根据当前文献提供用于在特定临床情况下选择最合适的成像程序的算法。这些指南由欧洲核医学协会(EANM)编写和授权,以促进最佳的癫痫成像,尤其是在儿童的术前环境中,青少年,和成人局灶性癫痫。他们将协助NM医疗保健专业人员以及神经学家等专家,神经生理学家,神经外科医生,精神科医生,心理学家,以及参与癫痫管理的其他人在癫痫发作发作发作区(SOZ)的检测和解释中进行进一步的治疗决策。所提供的信息应根据当地法律法规以及各种放射性药物和成像方式的可用性进行应用。
Epilepsy is one of the most frequent neurological conditions with an estimated prevalence of more than 50 million people worldwide and an annual incidence of two million. Although pharmacotherapy with anti-seizure medication (ASM) is the treatment of choice, ~30% of patients with epilepsy do not respond to ASM and become drug resistant. Focal epilepsy is the most frequent form of epilepsy. In patients with drug-resistant focal epilepsy, epilepsy surgery is a treatment option depending on the localisation of the seizure focus for seizure relief or seizure freedom with consecutive improvement in quality of life. Beside examinations such as scalp video/electroencephalography (EEG) telemetry, structural, and functional magnetic resonance imaging (MRI), which are primary standard tools for the diagnostic work-up and therapy management of epilepsy patients, molecular neuroimaging using different radiopharmaceuticals with single-photon emission computed tomography (SPECT) and positron emission tomography (PET) influences and impacts on therapy decisions. To date, there are no literature-based praxis recommendations for the use of Nuclear Medicine (NM) imaging procedures in epilepsy. The aims of these
guidelines are to assist in understanding the role and challenges of radiotracer imaging for epilepsy; to provide practical information for performing different molecular imaging procedures for epilepsy; and to provide an algorithm for selecting the most appropriate imaging procedures in specific clinical situations based on current literature. These
guidelines are written and authorized by the European Association of Nuclear Medicine (EANM) to promote optimal epilepsy imaging, especially in the presurgical setting in children, adolescents, and adults with focal epilepsy. They will assist NM healthcare professionals and also specialists such as Neurologists, Neurophysiologists, Neurosurgeons, Psychiatrists, Psychologists, and others involved in epilepsy management in the detection and interpretation of epileptic seizure onset zone (SOZ) for further treatment decision. The information provided should be applied according to local laws and regulations as well as the availability of various radiopharmaceuticals and imaging modalities.