视频脑电图对颞叶内侧癫癎致癎灶定侧价值探讨

Value of video-EEG lateralizing epileptogenic zone in patients with mesial temporal lobe epilepsy

目的：探讨视频脑电图（V—EEG）对颞叶内侧癫癎（MTLE）致痼灶定侧的价值。方法：回顾性分析34例MTLE患者的发作间期及发作期V—EEG提供的致癎灶的侧别信息，并与术中深部电极检测到颞叶内侧部位的痫样放电的侧别进行比较。结果：发作间期、发作期V-EEG能定侧的分别是23例（68％），29例（85％）。与术中深部电极检查定侧符合的分别是20例（87％），26例（90％），两者的定侧符合率比较差异无统计学意义（P〉0．05）。结论：MTLE患者发作间期痫样放电呈单侧分布或分布有绝对的侧别优势时，定侧意义较大，与发作期EEG对致癎灶定侧意义相当。

Objective：To assess the value of video-electroencephalography （V-EEG）lateralizing epileptogenic zone in patients with mesial temporal lobe epilepsy（MTLE）. Methods： The informations about lateralization of epileptogenic zone acquired from interictal V-EEG and ictal V-EEG in 34 patients with MTLE were retrospectively analysed. The result was compared with the side of epileptiform discharges detection by intraoperative depth electrodes. Result：The epileptogenic zone was lateralized in 23 patients by interictal V-EEG,in 29 patients by ictal V-EEG. The concordance rate of interictal V-EEG and ictal V- EEG with intraoperative depth electrodes was 87 % （20/23）and 90% （26/29）respectively in lateralization of epileptogenic zone. There was no significant difference between them（P〉0.05）. Conclusion.. When interictal epileptiform discharges have unilateral distribution or absolute side predominance, the value of interictal V-EEG is comparable to ictal V-EEG in lateralization of epileptogenic zone,while the significance of lateralization is more obvious.