深部电极对颞叶癫痫定位的应用研究

The use of depth electrodes in hippocampalEEGs monitoring for localizing the epileptogenic zone in temporal lobe epilepsy

目的 探讨深部电极脑电监测对颞叶癫痫灶定位的意义和安全性。方法 对 12例颞叶癫痫病例 ,无创检查难以定位或定侧者 ,在立体定向指引下颅骨钻孔行双侧或单侧海马区深部电极植入 ,脑电监测对癫痫灶定位 ,根据手术中皮层电极及深部电极癫痫灶的定位、手术后疗效评价及术后脑电检查结果 ,研究深部电极脑电监测对致痫灶定位的准确性和安全性。结果 12例病人埋置深部电极 2 3只 ,留置时间平均 5天 ;监测时间平均 10小时 ,明确定位 5例 (37.5 % ) ,定侧的 7例 (6 2 .5 % ) ,并在术中和术后得到验证。所有病例无颅内出血和感染等并发症发生。结论 深部电极植入脑电监测对颞叶癫痫灶定位是行之有效的方法 ,可作为颞叶癫痫致痫灶定位的可靠指标 ;电极植入安全 ,定位准确性高。

Objective To investigate the role and safety of hippocampal depth EEGs monitoring to localize the epileptogenic zone in temporal lobe epilepsy (TLE).Methods The depth electrodes were implanted in hippocampus in the guidance of stereotaxy in 12 patients with temporal lobe epilepsy,whose epileptogenic zone were difficulty to be localized or lateralized.Epileptogenic zones were determined according to the performances of depth EEGs.The accuracy for localization of epileptogenic zones was evaluated based on the data of cortical EEGs and depth EEGs monitoring during operation,postoperative EEG recordings and clinical follow-up.Results 23 depth EEGs were used in 12 patients.The depth EEGs monitoring lasted mean 10 hours in mean 5 days.The epileptogenic zone were accurately localized in 5 patients (37.5%),lateralized in 7 patients (62.5%),no significant complication were observed.Conclusion The implantation of depth EEGs is a safe and effective method to localize and lateralize epileptogenic zones in patients with temporal lobe epilepsy.The depth EEGs is reliable for localizing epileptogenic zone.