规范化脑电图在难治性癫痫术前定位中的应用

Preoperative standard electroencephalography location in patients with intractable epilepsy

目的：探讨规范化脑电图（EEG）对难治性癫痫（IEP）术前定位的应用价值。方法：选择30例行手术治疗的难治性IEP患者，先行常规EEG检查，再行规范化EEG检查，（包括减、停药物、剥夺睡眠诱发、应用蝶骨电极等）描记清醒、睡眠两种状态下EEG的变化，重点描记睡眠中非快动眼睡眠（NREM）和快动眼睡眠（REM）期，检查时间为90～120min，以求用这种方法发现更多EP活动的起始灶。结果：规范化EEG检查法明显提高了EP波的检出率，与常规EEG相比，定侧定位率从43％提高到87％。睡眠状态下NREM期和REM期局灶性放电较清醒期明显增加。16例起始放电区域与手术部位一致。结论：睡眠周期中局灶性异常电活动以及发作起始侧的脑电改变，对定位致痫灶有较高价值。

Objective： To investigate the value of preoperative standard electroencephalography （EEG） location for patients with intractable epilepsy. Methods： Thirty patients suffering from intractable epilepsy received common EEG examination first, and after hospitalizatoin, standard EEG examination. According to different conditions of patients, reduction or stop of medicine, depriving sleep inducement, and sphenoid electric pole were deployed for 90 to 120 minutes. The results of standard EEG in the consciousness and in the sleep, especially in the NREM and REM term were obtained. Results. Compared with common EEG, standard EEG method significantly increased the positivity rate of epileptic wave（43% vs 87% ）. Local epileptic electric activity was much more increased in NREM and REM term than in consciousness. Original focus in EEG was unanimous with surgery position in 16 cases. Conclusion： Local abnormal electric activity in sleep cycle and EEG changes derived from epileptic focus hemisphere are of great value in epileptogen ic focus location.