磁共振波谱分析及皮层脑电图在难治性癫痫手术中的定位意义

Application of magnetic resonance spectroscopy combined with electrocorticogram in refractory epilepsy operation and its significance of localization

目的探讨磁共振波谱分析结合皮层脑电图在手术治疗难治性癫痫定位癫痫灶的意义。方法对16例难治性癫痫患者,根据其临床发作类型、体征、磁共振波谱分析、皮层脑电图定位癫痫灶,同时对癫痫灶进行手术干预。结果随诊6个月～5年。根据1996年Engel疗效分级标准评测:Ⅰ级为10例、Ⅱ级为2例、Ⅲ级为3例、Ⅳ级为1例。Ⅰ级、Ⅱ级12例为临床治愈,Ⅲ级3例为好转,治愈率为75%,治愈好转率为93.8%。结论磁共振波谱分析可在癫痫外科术前评估中发挥重要作用,结合皮层脑电图可提高致痫灶定位的准确率,提高手术的效果。

Objective To discuss the role of magnetic resonance spectroscopy（MRS） combined with electrocorticogram（ECoG） in locating epileptogenic zone in refractory epilepsy operation.Methods The epileptogenic focuses of 16 patients with refractory epilepsy were localized by their clinical types of seizures,signs,results of MRS and ECoG;Operation intervention was performed simultaneously.Results All the patients were followed up for 6 months to 5 years.The outcome was assessed by 1996 Engel Scale as follows：grade I,10 cases;grade II,2 cases;grade III,3 cases and grade IV,1 case.12 patients with grade I and II recovered after clinical treatment,and 3 patients with grade III improved.The cured rate was 75%,and improved rate after treatment was 93.8%.Conclusion MRS can play an important role in the preoperative evaluation of the refractory epilepsy surgery.MRS combined with ECoG can accurately localize the epileptogenic focus and improve the outcome of surgical treatment.