摘要
目的探讨颅内电极监测癫痫发作初始期脑电对致痫灶的定位价值。方法14例难治性癫痫患者,其临床、影像学检查及头皮脑电记录等不能精确定位致痫灶,经颅骨钻孔、埋置颅内深部和/或皮层电极,长程脑电监测并分析发作初始期脑电的异常放电节律和范围,对比术后病理学检查和随访结果,分析发作初期脑电定位致痫灶的准确性。结果记录到了47次临床发作。发作初期异常放电可分为4种形式:低幅快节律、尖波节律、高幅棘波节律和棘慢波节律。按异常放电范围可分为:局限性放电、区域性放电和广泛性放电。11例(78.5%)患者准确定位了致痫灶,术后癫痫发作消失(64.3%)或极少发作(14.2%),2例(14.2%)发作减少90%以上,1例(7.1%)术后无改善。结论颅内埋置电极脑电监测癫痫发作初始期异常放电形式、部位和异常放电范围是定位致痫灶可靠的方法。
Objective To explore the roles of long-term int racranial EEG recording in patients with intractable epilepsy for localizing epileptogenic zone.Methods Fourteen refractory epilepsy patie nts,whose seizure onsets were unabl e to be localized with CT /MRI imaging and scalp EEG recording,received in tracranial EEG monitoring with dept h and /or subdural strip electrodes.Results Seizure onset zone was detected by the ictal intracranial EEG recordings at the initial stage of seizures(n=47).Based on the data of pathological ex amination,postoperative EEG recordings and clinical follow-up,we found that(1)Epileptogenic zone were accurately localized in eleven patients(78.5%).They were seizure free or had rare se izures after surgery.(2)Seizure attack improved in two patie nts.(3)Seizure attack did not show any improvement in one patient.For all patients,no significant com plications were observed.Conclusions The implantation of in-tracranial electrodes in selected p atients is safe and effective.The position and extent of the initial icta l EEG discharges are reliable inform ation for localizing epileptogenic zone.
出处
《中国临床康复》
CSCD
2002年第24期3688-3689,共2页
Chinese Journal of Clinical Rehabilitation
关键词
癫痫
致痫灶
颅内电极
脑电图
癫痫手术
epilepsy
epileptogenic zone
intracranial electrodes
EEG
epilepsy surgery
