摘要
目的探讨脑磁图(MEG)联合神经导航在局灶性皮层发育不良(FCD)所致额颞癫痫手术治疗中的临床价值。方法回顾分析44例FCD所致额颞癫痫患者的资料。患者术前行致痫灶定位及智商、记忆和语言评估;MEG检查确定语言优势半球,明确语言、体感、运动功能区位置。术中应用美国Medtronic Stealhealth S7手术导航系统引导手术切除FCD,保护神经功能。术后1年复测智商、记忆和语言检查,手术前后数据统计分析。癫痫术后随访13~44个月,依照Engel′s分级标准,判定癫痫疗效。结果 MEG能够精确定位语言、体感、运动功能区和FCD致痫灶位置。44例患者中28例患者语言优势半球为左侧,16例在右侧。术后1年言语智商与总智商提高(P<0.05),记忆商、操作智商无明显变化(P>0.05)。FCD患者术后恢复良好,无语言及肢体功能损伤。癫痫疗效:Engel′sⅠ级18例,Engel′sⅡ级22例;Engel′sⅢ级4例。结论 MEG联合神经导航对于FCD所致额颞癫痫患者术前语言优势半球、FCD致痫灶的定侧、定位和指导手术切除FCD,术中保护皮层功能、避免严重术后并发症,提高癫痫手术疗效具有重要价值。
Objective To investigate the value of magnetoencephalograph（MEG）combined neuronaviga-tion in the operation of frontal and temporal epilepsy caused by focal cortical dysplasia（FCD）. Methods The dataof 44 cases of frontal and temporal epilepsy caused by FCD were analyzed retrospectively. The location of epilepto-genic zone and assessment IQ,memory and language of patients were tested before operation;MEG examinationconfirmed the language dominance hemisphere and clarified the scope of language function. The surgical navigationsystem was guided by the American medtronic steal health 7 surgical navigation system to protect the neurologicalfunction. IQ,memory and language examination were measured 1 year after operation,and the data were analyzedbefore and after operation. The patients were followed up for 13 ~ 44 months after operation,according to Engel′sclassification standard,the curative effect of epilepsy was determined. Results MEG can accurately localize thelocation of the language functional areas and FCD Epileptogenic zone. Of the 44 language functional areas,28 hadthe left hemisphere and 16 were on the right side. Statistics showed that the verbal IQ and total IQ increased（P 0.05）in 1 year after operation,and there was no significant change in memory quotient and operation IQ（P 0.05）. FCD patients recovered well,and no language and limb function damaged. The curative effect of epilepsy：18 cases of Engel′sⅠgrade,22 cases of Engel′s Ⅱ grade;4 cases of Engel′s Ⅲ grade. Conclusions MEG com-bined with neuronavigation plays an important role in the localization,localization and guidance of epileptogeniczone in patients with refractory frontal and temporal epilepsy caused by FCD,which can protect the cortex func-tion,avoid serious postoperative complications,and improve the therapeutic effect of epilepsy.
作者
郭韬
刘倩薇
武江
郭非
GUO Tao;LIU Qianwei;WU Jiang;GUO Fei(Department of Functional Neurosurgery,Hebei General Hospital,Shijiazhuang 050051,China)
出处
《实用医学杂志》
CAS
北大核心
2018年第9期1416-1419,共4页
The Journal of Practical Medicine
基金
河北省科技计划项目(编号:162777209)
河北省科技成果推广课题(编号:20170248)
关键词
脑磁图
神经导航
局灶性皮层发育不良
癫痫
手术
magnetoencephalograph
neuronavigation
focal cortical dysplasia
epilepsy
operation
