脑电功能磁共振同步联合对发作间期颞叶癫痫的研究

Studying Temperal Lobe Epilepsy in Interictal Epiletiform Discharges Using Simultaneous Electroencephalogram-functional MRI

目的研究伴有双侧海马硬化颞叶癫痫患者的脑功能活动。资料与方法7例颞叶癫痫患者,均为双侧海马硬化,其中男6例,女1例,平均年龄16.7岁。单纯部分性发作者4例、部分继发全面发作者3例。7例患者均接受了脑电功能磁共振同步联合检查。结果5例患者内侧颞叶有明显激活,2例颞叶激活区位于新皮层中;边缘系统和皮层下结构有较明显的激活;大脑皮层中的激活区主要位于中央区。组分析结果显示,负激活的脑区与经典的脑缺省模式脑区一致。结论内侧颞叶硬化与颞叶癫痫之间关系紧密,边缘系统和皮层下结构参与痫样放电的易化和传播,长期的异常放电会对癫痫患者的脑功能活动产生影响。

Objective To study the brain functional activities in temporal lobe epilepsy（TLE） with bilateral hippocampal sclerosis（HS）. Materials and Methods Seven TLE patients （mean age = 16.7years, range 5 - 32years, 6 males and 1 female） with HS were underwent simuhaneous Electroencephalogram-functional MRI （SEM）. Four patients demonstrated simple partial seizures, and 3 patients belonged to secondarily generalized seizures according to clinical type. Results The significant activity regions were illustrated in mesial temporal lobe in 5 cases , in neocortical temporal lobe in 2 cases and. also involved the limbic system such as cingulate gyrus, part of posterior insular lobe and the structures of midbrain. The activation of the cerebral cortex areas was mainly located in the central movement region. Group analysis showed that decreased activity regions of the brain were consistent with the classic default mode regions. Conclusion There was a close relationship between the medial temporal lobe sclerosis and temporal lobe epilepsy. The limbic system and subcortieal nuclei neurons were involved in the spread and regulation of the interictal epileptiform discharges. Long-term abnormal discharges would impact the brain function of TLE patients.