同步录像脑电图(VEEG)与皮层脑电图(ECoG)在难治性癫痫灶切除手术中的作用

ACTION OF VEEG AND ECOG IN THE SURGICAL TREATMENT OF REFRACTORY EPILEPSY

目的:探讨同步录像脑电图(VEEG)与皮层脑电图(ECoG)在外科手术切除难治性癫痫致痫灶中的作用。方法:回顾性分析28例难治性癫痫患者的临床发作类型,术前同步录像脑电图(VEEG)与磁共振成像(MRI)检查结果以及术中皮层脑电图(ECoG)反复多次多点进行检测的结果,并进行详细分析。结果:MRI异常8例,正常20例;所有病例在同步录像脑电图(VEEG)检查中均记录到痫样放电,而且20例(71％)记录到临床发作,痫样放电部位57％位于右额,颞,中央区:术中皮层脑电图(ECoG)检测全部病例亦见痫样放电,46.5％集中于右颞部,32％位于右额,颞,中央区。结论:难治性癫痫患者的手术治疗效果与癫痫灶的定位密切相关,MRI,VEEG,ECoG对难治性癫痫的痫灶定位有重要价值,其中皮层脑电图(ECoG)能更准确地认定痫灶范围。

Objective: To explore the action of VEEG and ECoG in surgical treatment of refractory epilepsy. Methods: The clinical seizure types, pre - operative cranial MRI, VEEG findings and intraoperalive ECoG was analyzed retrospectively in 28 patients with refractory epilepsy. Results: MRI showed abnormal change in 8 patients , 20 patients were normal. VEEG showed epileptifrorm discharges in all patients. Clinical seizure was recorded in 20 patients (71%) . The epileptic focus was found in the right frontal, temporal, central region. ECoG showed epileptiform discharges in all patients. The epileptic focus was found in the right temporal region (46%) , 35% was found in the right frontal, temporal and central region. Conclusion: the therapeutic effect of surgery in patients with refractory epilepsy was closely related with the location of the epileptic focus. MRI, VEEG, ECoG might be of important value in the localization of focus, ECoG might be more accurate.