Lennox-Gastaut综合征15例患者的脑电图特点及癎灶定位研究探讨

The characteristics of EEG and localization of epileptogenic foci in patients with Lennox-Gastaut syndrome

目的:探讨Lennox-Gastaut综合征(LGS)的脑电图特点及痴灶定位。方法:回顾性总结、分析15例LGS患者的多道多形式脑电图特点,结合影像学资料并用辅助癫癎偶极子定位系统分析。结果:15例中,13例患者可见到癎样放电优势侧,其中9例已行手术治疗,术中7例行皮质及深部脑电图探测,证实了术前定位。随访6个月至2年,9例中发作停止6例,发作频率减少75％、50％- 75％和无效各1例,总有效率为89％,显效率为78％。结论:LGS表现复杂,特点鲜明,其脑电图异常程度高,虽然癎样放电广泛,但大部分可通过多形式多道脑电图找到其癎波发放优势侧,并结合病因、临床表现、影像学改变及偶极子拟合等,找出原发癎灶并予以手术切除,并同时联合胼胝体切开术,可获得良好的治疗效果。

Objective：To explore the characteristics of EEG and localization of epileptogenie loci in patients with Lennox-Gastaut syndrome（LGS）. Methods ：The EEG of undergoing multiehannel,various types and combined with image data were analyzed in 15 patients with LGS. Epileptiform waves were also analyzed by dipole localization method. Results; Thirteen of 15 patients were recorded with unilateral predominance of epileptiform waves, was the surgical treatment performed in 9 eases. Seven of 9 patients were explored and identified by ECoG and depth EEG. Six months to 2 years follow-up was carried out after surgery, 6 （66.7%） of 9 patients were free from seizure, and the other3 （11. l%）seizure frequency was reduced by 75%, or from 50% to 75% and no marked change occured（ in 1 patient each）. The gross efficiency rate is 88. 9%, and conspicuous efficiency rate 77.8%. Conclusion： The patients with LGS have complicated manifestations and remarkable characteristics, EEG is more serious, and most of them can be recorded with the unilateral predominace of epileptiform w,lves. Epileptogenic zone should be found when combined with etiology , clinical manifestations, image data and dipole localization method, and so on. The best effect can be obtained when epileptogenic zone is reseeted in combination with corpus ealiosotomy.