在MRI、VEEG、DLM定位下手术治疗难治性癫痫

Location of epileptogenic zone by MRI, VEEG, DLM before surgical treatment of refractory epilepsy

目的探讨在MRI、长程视频脑电图（VEEG）、无创头皮偶极子（DLM）定位下手术治疗难治性癫痫的治疗效果。方法对25例药物难治性癫痫患者术前进行MRI、VEEG、DLM检查，并依据检查结果，在术前对致痫灶进行定位，部分患者参考磁共振波谱分析、正电子发射断层扫描结果，术中以皮层及深部电极验证，分别或同时进行病灶、前颞叶切除、皮层低功率热灼术。结果24例术后随访1—5年，失访1例。按Engel分级，I级22例，Ⅱ级2例，无Ⅲ级及以下病例。结论MRI、VEEG、DLM定位下，部分病例参考磁共振波谱分析、正电子发射断层扫描结果，手术治疗难治性癫痫可以获得满意效果。

Objective To investigate the effect of surgical treatment of refractory epilepsy after epileptogenic zone located by MR,long - term viedo - EEG, scalpe dipole method. Methods All 25 drug refractory temporal lobe patients have been examined by MRI, VEEG, DLM before operation some cases examined by MR spectroscopy or PET in addition Patients either seperately or simultaneously accepted lesion rescetion anterior temporal lobectomy or electrode - coagulation on cerebral cortexts according intraoperative cortical electrode monitoring. Results 24 cases were followed - up from 1 to 5 years 1 lost. Surgical effects were evaluated by Engel classification standard （22 cases Engel I ,2 cases Engel I ）. Conclusion The effects of surgical treatment of refractory epilepsy are satisfied after the epileptogenic zone located by MRI, long - term viedo - EEG, scalpe dipole method some even need MR spectroscopy or PET location additionally before operation.