脑磁图语言功能区定位在癫痫外科中的应用价值

Application of magnetoencephalography mapping language functional areasin epilepsy surgery

目的探讨脑磁图对我国的癫痫患者语言功能区的定位方法,以及该项定位应用于语言功能区附近的癫痫手术的价值。方法选取25例致痫灶定位于语言区附近的顽固性癫痫患者,给予适当的语言任务刺激,经脑磁图记录刺激后产生的诱发磁场,将数据与MRI叠加后定位语言功能区,并以此为依据结合神经导航应用于癫痫术中以保护语言功能。结果 25例癫痫患者成功完成语言任务检查,均成功定位出相应语言功能区,术后有4例出现短暂性语言功能障碍,不久恢复至术前水平。本组无永久性语言功能障碍或原功能障碍加重表现。结论脑磁图作为一项无创的功能性检查,能精确定位语言功能区。结合神经导航将使得手术更加安全、有效,在语言功能区附近的癫痫外科中有着重要的应用价值。

Objective The aim of this study is to explore methods to localize the eloquent cortex of patients with epilepsy whose mother tongue is Chinese.The study also evaluates the value of this localizing technology applied in epilepsy surgery near eloquent brain area.Methods 25 patients with intractable epilepsy whose epileptic focus were localized near eloquent brain area were candidated.After stimulated by appropriate language task,they were examined by megnetoencephalography,which can record the magnetic signals inducted by stimulation.We added the data to MRI to obtain the localization of language functional area,and combined it with neuronavigation to protect the language functional area in the epilepsy operation.Results All 25 patients accomplished the language task examinations,and all were localized language functional area successfully.4 patients had transient language functional defiency after operation,but returned to the preoperational level in the end.There was no patient showing permanent deficiency or getting worse than preoperation in language ability.Conclusion As an non-invasive functional examination,megnetoencephalography can localize eloquent cortex accurately.Combination of neuronavigation and megnetoencephalography would make the operation safer and more efficient.The technology has immense value in epilepsy surgery near language functional area.