摘要
研究目的： 根據現有研究顯示，認知功能障礙(CI)與阿茲海默症(AD)和老年癲癇(EE)的相關性偏高，臨床上最常見的兩大老年癲癇病因分別為腦血管疾病(CVD)和神經退化性疾病(NDD)，在兩個臨床上最常見的老年癲癇病因中，腦部核磁共振(Brain MRI ) 可以幫助我們精準的診斷腦血管疾病，而神經退化性疾病如最常見的阿茲海默症卻一直缺乏準確的影像診斷工具，直到近幾年腦部類澱粉正子攝影(FBB PET)的問世，才讓我們有客觀影像工具來診斷阿茲海默症，因此我們想藉由腦部類澱粉蛋白正子攝影來了解老年癲癇病人其腦部類澱粉蛋白的表現，近一步了解老年癲癇和退化性神經疾病的關聯性。 研究方法及資料： 本研究對於目前於中山醫學大學附設醫院追蹤與治療，且年齡超過45歲以上的癲癇病人，排除不符合收案條件的病人，依有無腦部結構病變者分為兩組，將此兩組病人進行腦部類澱粉影像學檢測，觀察其影像學上的特色。 研究結果： 老年癲癇患者腦部類澱粉沈積影像陽性率，遠大於正常老年人，且另發現三個腦部結構病變位置和腦波異常放電區及臨床癲癇表現明顯不符的病人，其腦部類澱粉蛋白沈積影像皆呈現陽性。 結論與建議： (一) 對於老年癲癇的病人，腦部類澱粉沈積影像陽性率高於正常老年人，這暗示我們老年癲癇發作和神經退化性疾病或是老化的腦部病生理變化相關性可能遠高於我們以往的認知。 (二) 腦部結構病變處和臨床癲癇表現或是癲癇腦波產生區明顯不同的老年癲癇病人，對於查無其他明顯癲癇病因之病人，建議可安排腦部類澱粉正子攝影檢查，釐清該病人癲癇發作是否為神經退化性疾病臨床前期症狀或是神經退化性疾病所導致。
並列摘要
Study purposes According to current research, elder patients with epilepsy have higher incidence of cognitive dysfunction and Alzheimer's disease. Vascular disease and neurodegenerative disease are the two most common causes of elder epilepsy in the clinic. Brain Magnetic Resonance Imaging (MRI) can help us accurately diagnose cerebrovascular diseases. However, there was no accurate imaging tool to diagnose Alzheimer's disease until the advent of brain amyloid photography (18F-florbetaben Amyloid PET, FBB) in recent years. We have perfect Imaging tools to diagnose Alzheimer's disease now. We also can verify the correlation between elderly epilepsy and neurodegenerative disease by this image tool. Therefore, we want to use brain amyloid positron photography to understand the brain amyloid burden of elderly epilepsy patients. Methods: Our study includes patients with epilepsy older than 45 years old who still follow up at Chung- Shan Medical University Hospital. According to the presence or absence of brain structural lesions, they are divided into two groups. The two groups of patients were complete brain amyloid PET. Result: The positive rate of brain amyloid deposition in elderly patients with epilepsy is much higher than elderly people without epilepsy. There were three patient’s clinical epilepsy semiology that was obvious, not correlated to brain structural lesion location in MRI. And those three patient Amyloid PET findings were positive. Conclusion: (1) For elderly patients with epilepsy, the positive rate of brain amyloid deposition is higher than that of normal elderly people. It may indicate the higher correlation between the elderly patient with epilepsy and neurodegenerative diseases (2) If there were no other obvious epilepsy etiology. We recommend complete Amyloid PET when elderly epilepsy patients whose brain structural lesions location is significantly not correlated to clinical epilepsy semiology.