摘要
目的探讨硬膜下电极脑电图(ECo G)监测对磁共振阴性癫痫患者致痫灶的定位作用。方法对经临床、影像学和头皮EEG检查不能确定致痫灶部位的6例难治性额叶癫痫患者,植入硬膜下条状电极进行视频EEG监测,观察颅内电极发作期及发作间期EEG变化,结合头皮EEG、临床发作结果对癫痫灶进行综合定位;术后随访,评估致痫灶定位的准确性。结果 6例患者颅内电极埋藏时间为2~5 d,每例监测到>2次临床发作并记录发作间期和发作期的异常放电活动。5例患者发作期颅内电极EEG均能准确定位,5例显示一侧局灶性放电起源,1例患者显示双侧放电起源。术后按Engel疗效分级:EngelⅠ级4例(57.1%),EngelⅡ级1例(14.3%),随访不满1年的按谭氏术后效果分级,达到了满意。结论颅内电极EEG监测可为癫痫手术治疗提供可靠的病灶定位依据。
Objective To explore the role of intracranial electrode EEG monitoring for localizing epileptogenic zone in epilepsy. Methods 6 patients with refractory frontal lobe epilepsy with non-lesional MRI findings, whose seizure onsets were unable to be localized by MRI, routine EEG and clinical characteristic, accepted long term intracranial electrode EEG monitoring. Bi frontal lobe subdural implanted trip electrode were used to perform the ictal and interictal EEG monitoring under the guiding of the stereotactic technique. The results routine of EEG, MRI and intracranial electrode EEG were combined. The accuracy for localization of epilepitogenic zone was evaluated based on the followed-up. Results The intracranial electrode EEG monitoring was implanted within 2-5 d. Each patient was recorded the ictal and interietal discharge and was detected clinical onsets at least twice. All patients could be localized by ictal EEG. 5 cases showed focal discharge and 1 with bilateral discharge. The clinical outcome showed that patients were seizure-free in 4 cases （57.1% ） , improved significantly in 1 （ 14.3% ） according to Engel＇s criteria after surgery. Followed by less than 1 year after the results of the postoperative grade Tan were satisfied. Conclusion The intraeranial electrode EEG monitoring can localize epileptogenic zone and offer reliable evidence for epilepsy surgery.
出处
《临床神经外科杂志》
CAS
2017年第5期342-345,共4页
Journal of Clinical Neurosurgery
基金
南京市卫生局资助项目(YKK14102)
关键词
额叶癫痫
致痫灶
颅内电极脑电图
frontal lobe epilepsy
epileptogenic zone
intraeranial electrode EEG
