颞叶癫痫手术时的皮质脑电描记

Electrocorticography in temporal lobe epilepsy surgery

提要报告1980年10月至1992年6月间,在皮质脑电描记下手术治疗颞叶癫痫55例,前颞叶切除50例,杏仁核、海马切除5例。皮质脑电描记结果说明,颞叶癫痫的痫灶绝大多数来源于颞叶外侧皮质和颞叶内侧结构。术中皮质脑电描记可提供痫灶的精确部位和范围。

Between 1980 and 1992, fifty five patients with temporal lobe epilepsy were studied retro-spectively in the Neurosurgery Department of Jinling Hospital of Nanjing. In the group of patients with temporal lobe epilepsy, there were 35 men and 20 women. Their age range was 11 to 55 years (mean 27 years). Anterior temporal lobectomy was performed in 50 patients, and 5 patients underwent amigdalohippocampectomy. The pre-operative localization of epileptogenic focus was based on EEG and neuro-radiological examination. All patients underwent intra-operative ECoG recording and depth electrodes prior to temporal lobe surgery. ECoG distribution of intenctal epileptic abnormal activity was as follow: 1.Spontaneuos spike activity was recorded from lateral surface neocortical temporal lobe in 6 patients without simultanoeus depth elctrodes recording. 2. Interictal epileptic abnormaly was recorded from lateral surface neocortical temporal lobe and mesial structure (amygdaloid and hippocampal) in 23 patients. 3. Spike activity located to lateral surface neocortical temporal lobe and mesiai structures and supra-sylvian region in 15 patients. 4.Spike activity was recorded from leteral surface neocortical temporal lobe but mesial structures without abnormal epileptic discharge in 5 patients. 5. Spike activity was recorded from the menial structures but lateral surface temporal lobe without epileptic activity in 6 patients. According to our results,epileptogenic focus of temporal lobe origin was located involving lateral temporal neocortex and mesial temporal lobe structures in 77.5纬of the patients being studied. The results of this study confirms that ECoG may provide the most accurate location and extent of the epileptogenic area.