蝶骨电极对颞叶癫痫致痫灶手术的定位价值

The surgical localization of the foci with sphenoidal electrodes in temporal epilepsy.

目的探讨蝶骨电极脑电图对颞叶癫痫致痫灶手术的定位价值。方法对５２例颞叶癫痫病人在手术前用常规电极和蝶骨电极描记脑电图，确定癫痫病灶。在手术中描记皮层电图（ＥＣｏＧ）及深部脑电图（ＤＥＥＧ）。结果用蝶骨电极描记者均有痫样放电（１００％），其中９０％局限于颞叶；而常规头皮电极发现有痫样放电４６例（８８％），局限于颞叶者只占４６％。术中ＥＣｏＧ和ＤＥＥＧ证明所有病人的颞叶表面、海马或杏仁核均有痫样放电。结论在诊断颞叶癫痫中蝶骨电极较为可靠，有助于手术前的定位诊断，并且可提高颞叶癫痫脑电图的阳性率４４％。

Objectives To explore the surgical localization of the foci with sphenoidal electrodes in pati:ents wifh temporal epilepsy. Methods The surgical localization of the foci with sphenoidal electrodes was analyzed in 52 pati;ents with temporal epilepsy. Results All cases have abnormal epileptiform discharges and 90%of them localized in temporal lobe by syhenoidal electrodes. The surgical recording with cortical electrodes (ECoG) and depth electrodes, reveal that all cases with temopral epilepsy were found epileptiform discharges on the surface of temporal lobe or hippocampus or corpus amygdaloid nucleus, which demonstrate the reliability and helpfulness of sphenoidal electrodes for the surgival localization. Conclusions The sphenoidal electrodes could increase the positivity rates of electroencephalography in patients with temporal epilepsy by 44%