皮层脑电图在脑肿瘤继发性癫手术中的应用

CLINICAL APPLICATION OF ELECTROCORTICOGRAPHIC MONITORING IN THE OPERATION OF PATIENTS WITH BRAIN TUMOUR AND SECONDARY EPILEPSY

目的:研究皮层脑电图(ECoG)监测在脑肿瘤继发癫患者手术中的应用价值。方法:对13例患者行头皮常规脑电图(REEG)检查,在手术过程中应用皮层脑电图(ECoG)先确定癫灶的范围,切除原发肿瘤病灶后再行皮层脑电描记,并与切除前进行比较,对仍有癫样波的皮层行双极电灼,尽量电灼至癫波消失。结果:13例患者术前ECoG均异常,均可见较多尖、棘波,尖慢波,切除病灶后2例尖、棘波明显减少,11例病灶周围仍有较多棘波,行双极电灼后9例棘波消失,2例偶见单个尖波。结论:在脑肿瘤继发癫患者手术中应用ECoG对准确探查癫灶的部位及范围,指导手术切除范围,减少术后癫发作有重要价值。

Objectives：To explore the clinical applied value of electrocorticogramy （ECoG） in the operation of patients with brain turnout and secondary epilepsy. Methods： EEG was done in 13 patients with brain tumour and secondary epilepsy. Epileptogenic loci were first determined by ECoG. ECoG was compared after the excision of tumour. The cortex with epileptiform waves was burnt by electric ambipolar until epileptiform waves disappeared. Results：ECoG was abnormal in 13 cases before the excision of tumour. Much sharp - spike waves and spike - slow wave were detected by ECoG. Sharp - spike waves were fewer in 2 cases and many in 11 cases after the excision of tumour. Spike waves disappeared in 9 cases and single spike wave was detected in 2 cases after the cortex was burnt by electric ambipolar. Condusioas：ECoG might be of importment value in the localization of epileptogenic loci in the operation of patients with brain tumour and secondary＂ epilepsy.