摘要
目的：探讨对比脑电偶极子定位法（DLM）和颅内电极埋藏在致痫灶中的定位价值。方法：对36例头皮脑电图不能定位而必需先置颅内电极埋藏定位致痫灶，再行开颅致痫灶切除的病例，根据头皮长程视频脑电图监测，对痫样放电进行DLM，并以埋藏皮层及深部电极记录的脑电定位致痫灶为标准对照，中心位置相距15mm以内为偶极子定位与之吻合，进行对比分析。结果：36例患者中，17例发作间期的痫样放电传导较局限，DLM比较埋藏电极记录定位，两者吻合率高达94％；对于9例起源灶较局限位于深部的病例吻合率亦较高（78％）；有10例发作间期有多个激惹灶存在，放电范围广泛，DLM偏离较远，吻合率仅为20％。本组36例均记录到有发作期的脑电活动，发作起始期DLM偏离较远，两者吻合率仅为25％。结论：DLM是一种很好的癫痫起源灶分析方法，是术前评估的有力手段之一，与其他致痫灶定位方法是相互验证、相互补充的关系，合理使用DLM技术可以适当减少颅内电极埋藏定位致痢灶的使用，但目前尚不能完全相互替代。
Objective：To investigate the value of EEG dipole location method （DLM） and intracranial electrode implantation in the location of epileptogenic foci. Methods： In 36 cases with epilepsy whose epileptogenic foci could not be located by EEG, intracranial electrode implantation of the epileptogenic foci was performed first and then craniotomy and resection of the epileptogenic loci were made. According to the scalp long term video EEG monitoring, DLM was adopted to epileptic discharges, and then EEG cortical and deep implanted electrode recordings of epileptogenic foci were comparatively analyzed under the standard control of location （the center position within 15 mm as anastomosis with the dipole location）. Results：In I7 patients out of 36 cases electrical conduction was limited during epileptic discharges In comparison with DLM, the anastomosis rate of the implanted electrodes to record the location reached 94.1%. In 9 patients with lesions located in deep position, the anastomosis rate was also limited, with a higher rate of 77.8%. And in 10 cases with interictal multiple bowel lesions, the discharge range was wide; DLM deviated far away, the anastomosis rate was only 20%. In 36 cases of this group the out break period and starting period were recorded; DLM deviated far off, and the anastomosis rate was 25 %. ConclusionDLM is a helpful analysis of the origin of epileptic loci, one of the powerful devices of preoperative assessment. Compared with other epileptic loci positioning method in mutual authentication and mutually complementary, the rational use of DLM technology can be appropriate to reduce intracranial electrodes implanted locate epileptic foci. Therefore DLM cannot be completely replaced at present.
出处
《癫痫与神经电生理学杂志》
2015年第4期207-210,共4页
Journal of Epileptology and Electroneurophysiology(China)
基金
江西省赣州市科技局项目（编号：2012116）
关键词
脑电偶极子定位法(DLM)
颅内电极埋藏
致痫灶定位
手术治疗
dipole localization method （DLM）
intraeral
electrode implantation, localization ofepileptogenic focus operation treatment
