颞叶癫痫发作初期头皮和颅内脑电定位价值的比较研究

A comparative study on the value of epileptogenic zone localization between scalp EEG and intracranial EEG in patients with temporal lobe seizures

目的比较研究颞叶癫痫发作初期头皮脑电(sEEG)和颅内脑电(iEEG)的特点,探讨有定位意义的EEG指标。方法常规行长程视频EEG(Video-EEG,V-EEG)监测,以捕捉到3次以上发作为标准。对sEEG难以定位的患者采用颅内埋置硬膜下和(或)深部电极,记录iEEG。结果本组20例资料显示,sEEG和iEEG的定位检出率分别为50%和100%。经iEEG记录分析,7例sEEG不能定侧者5例完成定侧,10例广泛性sEEG异常者均定位为区域性或局限性表现。结论低幅快节律、棘波和尖波节律具有重要的的定位价值;80%的sEEG低幅快节律表现者,与iEEG监测中表现一致;80%的sEEG颞叶棘波表现者,在iEEG监测中存在尖波节律。iEEG能明显提高致痫灶的定侧和定位准确性。

Objective By analyzing the features between scalp EEG and intracranial EEG in initial temporal lobe seizures to find out significant EEG parameter of epilepsy orientation. Methods Taking the routine EEG records and catching three times of outbreak as criteria. The strip, deep or grid electrodes were implanted in those patients who were difficult to locate epileptogenic zone with noninvasive. Methods The chronic Video--EEG monitoring were used to capture of the initial features of seizures. Results Data of 20 cases in our group showed that the positive rate of sEEG and iEEG was 50% and 100% respectively. The localization was accomplished according to intracranial EEG in 5 of 7 cases showing bilateral discharge in sEEG. The range was also regionalized by intracranial monitoring in 10 cases with extensive sEEG discharge. Conclusion Low rapid activity and spike rhythm showed significant localizing value in TLE. Eighty percent of patients with low rapid activity in sEEG showed the same trait in iEEG monitoring, and 80% of patients with spikes in sEEG showed spike rhythm in iEEG monitoring. Intracranial EEG significantly increas the accurate rate of localization of seizure focus in temporal lobe epilepsy.