长程视频脑电图监测在癫痫外科中的临床意义

Clinical Significance of Video-EEG Monitoring in Epilepsy Surgery

目的探讨视频脑电图(V-EEG)监测在癫痫外科中的作用。方法31例均行常规脑电图(REEG)和V-EEG检查,其中有8例在经过详细的术前评估后行了手术治疗,术中均行了皮层脑电图(ECoG)监测,并将V-EEG与REEG和ECoG的监测结果进行比较。结果31例V-EEG监测显示轻度异常脑电图2例,中度异常脑电图18例,重度异常脑电图11例。除1例外,其它在监测中均发现有痫样放电,痫样放电的阳性率为96.8%(30/31),16例(51.6%)在监测中至少观察到1次临床发作。V-EEG监测痫样放电的阳性率与REEG(38.7%)之间经统计学比较有极显著性差异(P<0.01)。同时,V-EEG与ECoG的定侧符合率为100%,定位符合率为75%。结论V-EEG监测在难治性癫痫患者术前定位致痫灶方面具有一定的指导意义,它明显优于REEG,且与术中ECoG有很高的符合率。

Objective To explore the clinical significance and effect of video--EEG（V--EEG） monitoring in epilepsy surgery.Methods In this group there were 16 males and 15 females,All the patients underwent routine EEG（REEG） and V-EEG, and aftercareful pre- operative evaluation,8cases underwent operations.During the operation,electrocorticogram（ECoG） monitoring was per-formed.The results of V--EEG monitoring were compared with REEG and ECoG.Results The result of V--EEG monitoring showedslightly abnormal EEG inlcase,moderately abnormal EEG in20and severely abnormal EEG in 11 .Except forlcase, epileptic dis-charges were recorded in all cases, and the positive rate of epileptic discharge was96.8%（30/31）.At least one attack was observed in16cases（51.6%）.There was significant difference in the positive rate of epileptic discharge between V--EEG and REEG（P〈0.01）.Meanwhile, the concordant rate of V--EEG and ECoG in lateralization was100% and localization 75%.Conclusion V-EEG monitoringhas some significance in preoperative localization of epileptic lesion of refractory epilepsy cases.