磁源性影像在MRI阴性的结节状灰质异位伴癫痫发作患者中的应用

The application of magnetic source imaging in epileptic with MRI negative nodular gray matter heterotopia

目的:探讨磁源性影像(MSI)在MRI阴性的结节状灰质异位伴癫痫发作患者中的应用价值。方法:对6例病理证实为结节状灰质异位的MRI阴性的患者行MSI检查,进行发作间期神经元癫痫样放电的定位。结果:患者中5例癫痫灶位于颞叶,此5例行前颞叶及海马切除;1例癫痫灶位于右侧额顶中央区,行右额顶癫痫灶切除。所有6例患者均为结节状灰质异位,其中4例伴有局灶性脑发育不良或微发育不良,4例伴有海马硬化。随访结果中依据南京军区总医院评估标准,疗效满意者5例(5/6),显著改善者1例(1/6)。结论:MSI可提示灰质异位伴发癫痫患者的癫痫灶定位,是术前无创伤性定位的有效手段,通过手术治疗可取得良好的效果。

Objective：To evaluate the value of magnetic source imaging（MSI） in epileptic with MRI negative nodular gray matter heterotopial.Methods：6 epileptic patients with MRI negative nodular gray matter heterotopia had MSI examination for localizing the epileptic focus.Results：The epileptic foci were localized at temporal lobe in 5 cases,the anterior temporal lobe and hippocampus were resected.The epileptic focus was localized at central zone of right frontoparietal lobe and resected in 1 case.All of the 6 patients were nodular gray matter heterotopia pathologically,together with focal cortical dysplasia or microdysplasia in 4 cases,hippocampal sclerosis in 4 cases.According to the assessing standard of Nanjing general military hospital,the result of follow up were satisfied in 5 cases and marked improved in 1 case.Conclusion：MSI can prompt the epileptic focus in patients with gray matter heterotopia.It is an effective location method preoperatively and the patients can achieve good outcome by surgery.