颞叶癫痫术前定位方法的评价

Evaluation of preoperative location methods for temporal lobe epilepsy surgery

目的探讨颞叶癫痫不同术前定位方法的效果。方法回顾性分析58例难治性颞叶癫痫手术患者的临床资料,分别统计头皮脑电图、视频脑电监测、皮层电极、深部电极、头颅CT、MRI、PET七种检查定位方法的阳性结果,计算出准确定位率,对数据进行统计学分析。结果CT、头皮脑电图的定位能力明显低于视频脑电监测、皮层电极、深部电极监测及MRI、PET检查,后五种评估方法的定位能力无显著差异。结论上述术前定位方法单一应用不具有特异性,颞叶癫痫灶的准确定位需综合应用各种定位方法。

[Objective] To explore the abilities of different preoperative location methods and the appropriate integrated methods to localize epilepsy focus for temporal lobe epilepsy. [Methods] Analysed retrospectively the data of 58 refractory temporal lobe epilepsy eases from January 2000 to July 2006. Seven special examinations, including scalp electroencephalogram （EEG）, video-eleetroencephalographic monitoring （Video EEG）, cortex electroencephalogram （ECoG）, depth electroencephalogram, computer tomography （CT）, nuclear magnetic resonance imaging（MRI）, Positron emission tomography （PET） were considered. The sum of all patients and the positive findings were calculated, then obtained the data of accurate localization. We compared the positive results of each examination with the ultimate localization results, and calculated the precise rate of localization, and made statistics analysis. Results： The number of 58 eases examined by scalp EEG, Video-EEG, ECoG, depth EEG, CT, MRI, PET was respectively 58,40,58,58,35,58,36, accurate rate of localization was 30/58, 34/40, 52/58, 51/58, 11/35, 47/58, 31/36. The abilities of localization of CT and sealp electrodes EEG was obviously inferior to Video-EEG, ECoG, depth electroencephalogram, MRI, PET. There were not significant diserepancies among Video-EEG, ECoG, depth EEG, MRI, and PET. [Conclusions＇] Of all seven preoperative evaluation methods, each has no speeifieities. In order to localize accurately the epilepsy focus, the combination of these methods is needed.