颅内电极脑电图对难治性癫患者致间疒灶定位的作用

Positioning effect of intracranial electrode EEG on epileptogenic focus in patients with refractory epilepsy

目的研究颅内电极脑电图（EEG）对难治性癫患者致灶的定位作用。方法对 10例难治性癫患者行颅内深部和/或皮质电极置入术及颅内电极EEG监测4~14 d,并与常规EEG、MRI、PET对致灶定位及手术中所见比较;观察颅内电极置入术的并发症及癫手术治疗结果。结果 10例患者经颅内电极EEG监测后均明确了致灶,其中与常规EEG一致2例,不同8例;与MRI、PET病灶一致4例,不同6例;电极置入术后出现脑脊液漏3例,硬膜下血肿、电极折断及颅内感染各1例。10例患者在致灶切除术中发现的致灶与颅内电极EEG所示部位吻合;术后随访7~17个月,所有患者抗癫药物减量,癫发作控制。结论颅内电极EEG对难治性癫患者的致灶具有准确的定位作用。

Objective To study the positioning effect of intracranial electrode EEG on epileptogenic focus in patients with refractory epilepsy.Methods The deep brain and/or cortical electrode implantation were underwent in 10 patients with refractory epilepsy and their intracranial EEG were monitored for 4-14 d.The results of epileptogenic focus found by intracranial electrode EEG were compared with routine EEG,MRI,PET and operative foundings.The complications of the cortical electrode implantation and the result of epileptis opreation were observed.Results The epileptogenic focus of the 10 patients had been defined by intracranial EEG.Compared with routine EEG,which were same in 2 cases,difference in 8 cases.Compared with MRI and PET,which were same in 4 cases,difference in 6 cases.Postoperative complications were the cerebrospinal fluid leakage in 3 cases,the subdural hematoma,electrode fracture and intracranial infection in 1 case.In the 10 cases,the locations of the epileptogenic focus found in the operation or by intracranial EEG were same.Followed-up for 7-17 months after operation,all the patients reduced the antiepileptic drugs and their seizures cloud be controlled.Conclusion The intracranial EEG has the role of accurate positioning of epileptogenic focus in patients with refractory epilepsy.