颞叶癫痫颅内外脑电同步记录的临床研究

Clinical Study on Synchronous Recording of Intracranial and Extracranial Electroencephalogram in Temporal Lobe Epilepsy

探索颅内外脑电图同步记录对颞叶癫痫的临床价值。对难以定侧,高度怀疑为颞叶癫痫,并且诊断为难治性癫痫患者行双颞钻孔,置入颅内电极,同步记录10-20头皮、双侧蝶骨和颅内脑电。对最终确认的颞叶癫痫患者,分析其同步脑电图,测量发作从颅内起源传播到颅内外各个目标电极点的时程,推测发作期放电在颅内外传播顺序。分段记数3h发作间期双侧蝶骨电极癫痫样放电的数量,分析蝶骨间期放电的定侧意义。颞下、海马、颞极和颞叶中外侧各部位起源的大多数发作在颅内外传播有各自的方式,间期蝶骨电极放电数目病灶侧明显多于非病灶侧。颅内电极对难以定侧的颞叶癫痫有关键的帮助,颅内外脑电图同步记录的方法有益于颞叶癫痫灶的定侧。

This paper explores the clinical significance of synchronous recording of intracranial and extracranial EEG in temporal lobe epilepsy. Intracranial electrodes were implanted in highly-suspected refractory temporal lobe epilepsy patients to lateralize the epileptic focus. Intraeranial and extracranial EEGswere synchronously recorded and analyzed for finally diagnosed temporal lobe epilepsy patients. Time intervals from seizure onset to every electrode were recorded. The propagation patterns were deduced. Numbers of lnterictal Epileptic Discharges （IEDs） at bilateral PG were counted for intermittent 3 hours to find its lateralization significance, lctal discharge propagation sequence of inferior temporal area, hippocampus, temporal pole area, and lateral middle temporal area are found to follow certain rules in most attacks. Number of IEDs in epileptic focus side is greater than that in non-focus side. IEEG is important to patients whose focus lateralization are hard to be identified before operation. Synchronous recording of intracranial and extracranial EEGs help the focus lateralization in temporal lobe epilepsy.