颅内电极记录在定位颞叶癫痫致痫灶中的应用研究

Application of intracranial electrode for location of epileptogenic zone in temporal lobe epilepsy

目的 通过侵袭性的术前检查 (颅内电极记录 )对颅内电极记录适应证进行分类 ,了解此方法可靠性及并发症。方法 1998～ 2 0 0 3年间 ,对 2 7例药物难治性颞叶癫痫患者进行颅内电极植入 ,方法包括 :双侧颞叶纵向深部电极植入、双侧硬膜下颞底条状电极植入、颞外条状电极植入。结果 术前进行广泛的无创检查之后仍不能定位致痫灶的 2 4例患者 ,通过颅内电极记录确定了手术。结论 对于一些难以决定是否适合手术的癫痫患者 ,颅内电极记录是一种有效。

Objective In some candidates for epilepsy surgery in whom the decision to operate is difficult to make,invasive presurgical investigation,namely intracranial electrode recording,may be needed.This study is to clarify the indication for intracranial electrode recording,to expose its complication,to display its usefulness in terms of surgical strategy and results.Methods 27 patients,suffering from drug resistant temporal lobe epilepsy and selected as surgical candidates,underwent intracranial electrode recording between 1998 and 2003.Standardized placement for intracranial electrode included:longitudinal placement of bilateral temporal lobe depth electrode,bilateral subtemporal subdural strips,extra temporal lobe subdural strips.Results If epileptogenic focus couldn't be well defined after extensive noninvasive presurgical evaluation,there was indiction for intracranial recording.And the study showed that intracranial electrode recording was helpful in most (88.9%) of 27 patients to confirm of annul surgical indication.Conclusion Intracranial electrode recording proves to be a relatively safe and a very useful method in difficult candidate for epilepsy surgery.