部分性癫痫二例发作间期同步应用脑电图-功能磁共振成像定位致痫灶

Electroencephalogram-functional magnetic resonance imaging study of the interictal epileptic activity in two patients with partial epilepsy

目的探讨部分性癫痫痫性放电相关血氧水平依赖（BOLD）信号的分布规律，为进一步研究该病的发病机制、脑功能变化奠定基础。方法采用同步脑电图-功能磁共振成像（EEG-fMRI）技术，对2例部分性癫痫患者进行发作间期痫性放电相关BOLD变化的研究，探讨该病发作间期痫性放电相关BOLD信号与临床脑电图定位脑区的相互关系。结果2例患者的临床脑电图定位脑区均出现了最大激活信号，其中1例在该区域有2处显著激活；在该区对侧相应脑区也有较弱的激活信号出现。结论部分性癫痫痫性放电相关BOLD反应以痫性放电脑区为主，但其对侧同源脑区也有较弱的激活信号，fMRI激活信号与脑电活动之间有着很好的对应关系。

Objective To investigate the map and pattern of blood oxygen level dependent （BOLD） signal changes correlated to interictal epileptiform discharges （IEDs） with EEG-fMRI in patients with partial epilepsy and then to explore the pathophysiological mechanisms of epileptic discharges and their effect on brain function in partial epilepsy. Methods Through the method of EEG-fMRI, 2 patients with partial epilepsy were studied. The relationship between the regions of BOLD signal changes linked to IEDs and the electroclinical localization of epileptogenic zone in patients with partial epilepsy were investigated. Results The epileptogenic areas localized by electroclinical findings in the 2 patients all showed maximal activation and 2 sites of significant activation were found in 1 of the 2 patients ; Weak activation were also manifested in the opposite side corresponding to lesions. Conclusions IED-linked BOLD response in patients with partial epilepsy is mainly in epileptogenic zones and weak activation can also be seen in the corresponding contralateral areas of epileptogenic zones. Activation areas are well concordant with epileptogenic areas localized by electroclinical findings.