摘要
目的评估颅内EEG(intracranial EEG,iEEG)监测在致痫灶定位中的可靠性和安全性。方法头皮EEG(scalp EEG,sEEG)监测致痫灶定位困难的顽固性癫痫患者46例,采用颅内硬膜下和(或)脑内电极,长程视频iEEG监测。根据术中痫样放电的表现、术后病理结果、疗效和sEEG复查结果,分析iEEG定位致痫灶的价值。结果深部电极埋置8例、硬膜下电极埋置17例、二者联合应用21例;电极留置4-23d,平均8·6±3·8d;iEEG监测8-552h,平均132±34h;捕捉到发作436次,平均9·4±7·8次。术后随访1年以上,82%(38/46)的患者癫痫发作完全消失或基本消失(少于2次/年),无严重并发症发生。结论对于那些无创检查不能明确致痫灶的病例,iEEG是一种安全可靠的定位方法。
Objective To investigate the role and safety of intracranial electrodes for localizing epileptogenic zone in patients with intractable epilepsy. Methods The subdural and/or depth electrodes were implanted in 46 patients. Epileptogenic zones were determined according to the performances of longterm video iEEG. The accuracy for localization of epileptogenic zones were evaluated based on the data of iEEG monitoring, pathological examination, postoperative EEG recordings and clinical follow-up. Results Subdural electrodes were used in 8 patients, depth electrodes in 17 patients, both subdural and depth electrodes in 21 patients, The electrodes were implanted for 4 - 23 days （ mean 8. 6 ± 3.8 days ）, and the iEEG monitoring lasted from 8 to 552 hours （mean 132 ± 34 hours）. Epileptic activities were detected at the initial stage of seizures （ n = 436 mean 9. 4 ± 7. 8 ） in all of 46 patients and 82% （ 38/46 ） were accurately localized. No significant complications were observed. Conclusions The implantation of subdural and depth electrodes to localize epileptogenic zones in selected patients is a safe and effective method.
出处
《中华神经外科杂志》
CSCD
北大核心
2005年第8期452-456,共5页
Chinese Journal of Neurosurgery
