LONG-TERM SURFACE CORTICAL CEREBRAL BLOOD-FLOW MONITORING IN TEMPORAL-LOBE EPILEPSY

LONG-TERM SUBDURAL SURFACE cortical cerebral blood flow (CBF) and elec trocorticographic monitoring was performed in 12 patients with complex partial seizures. A total of 40 seizures were analyzed. Baseline CBF values from nonepileptic and epileptic temporal lobe (mean +/- standar d error) were 60.0 +/- 1.0 and 50.2 +/- 1.8 ml/100 g per minute, respe ctively (P < 0.05). In general, clinical seizure onset was preceded by a 20-minute preictal CBF increase from baseline in the epileptic temp oral lobe. Peak early postictal CBF values of nonepileptic and epilept ic temporal lobes were 57.7 +/- 13.3 and 89.0 +/- 21.7 ml/100 g per mi nute (P > 0.05) at 5.2 +/- 2.2 and 2.4 +/- 1.0 minutes (P > 0.05) afte r clinical seizure onset, respectively. Statistically significant diff erences between nonepileptic and epileptic temporal lobe CBF were dete cted at 50 minutes (74.0 +/- 14.2 and 37.5 +/- 9.2 ml/100 g per minute , respectively; P < 0.05) and 60 minutes (75.6 +/- 13.6 and 36.1 +/- 8 .5 ml/100 g per minute, respectively; P < 0.05) postictal. The data su ggest that the optimal times for CBF analysis to differentiate epilept ic from nonepileptic temporal lobe are 1) during the interictal period and 2) late (50 to 60 minutes) postictal. The results of this study s hould improve the understanding of the dynamic cerebral perfusion patt erns in the epileptic human brain.