癫癎诊疗中应用头皮脑电图偶极子定位的体会

Comprehension of effects of treatment for epilepsy by dipole location of scalp EEG

目的总结癫癎诊疗中应用头皮脑电图偶极子定位在术前、术中、术后的意义。方法回顾性分析29例行偶极子源成像定位癫癎灶、17例进行手术治疗,术中与皮层脑电图、深部电极记录对比,参考手术治疗效果。结果术后随访无癫癎发作或偶有先兆发作12例,发作形式改变(术前大发作变为小发作)和发作次数减少75%以上3例,发作次数减少不到50%1例,无变化1例,手术总有效率为94%。结论头皮EEG偶极子的术前定位方法无创、准确,可避免创伤性检查用于癫癎病人的术前定位。

Objective To discuss the effects of the treatment for epilepsy by dipole location of scalp（DLM） EEG in prei-operation. Methods Retrospectively analyzed the clinical data of 360 epilepsy cases in which 29 cases accepted DLM to locate the epileptogenic zone and 17 cases accepted operation, which compared with cortical EEG or depth electroencephalogram and reference the effect. Results In post-operative follow-up, there were 12 cases of no epilepsy attack or occasional epileptic aura, 3 cases with improved onset mode （ GM seizure changed to absence seizure ）and less onset frequency （ more than 75% less than before ） , 1 case with onset frequency less than 50% less than before, and 1 case not improve. The total effective rate of operation was 94%. Conclusions The method of pre-operative location by DLM is correct and no injury, similar to MEG. DLM could be used for epilepsy pre-operative location to avoid traumatic examination.