颞叶新皮层癫痫的颅内电极研究

Epilepsy patients with localized lateral temporal lobe lesion： intracranial EEG study and surgery making

目的对于颞叶新皮层存在局灶性损害的癫痫患者，应用颅内电极记录新皮层病灶部位及海马的发作期电活动，以判断海马是否是独立的致痫灶。方法总结8例患者，入选标准：MRI显示一侧颞叶新皮层存在局灶性的损害，双侧海马形态基本正常，无萎缩及肿胀等变化；术后随访1年以上。分析颅内脑电图临床发作及电发作的起源部位。结果颅内脑电图共记录到临床发作65次，电发作16次，其中起源于颞叶内侧的临床发作24次，电发作7次。仅1例患者所有发作均起源于新皮层，其余7例均有独立起源于海马的临床发作或电发作。结论颅内脑电图记录显示在颞叶新皮层存在局灶性损害的癫痫患者，海马是重要的独立致痫区，MRI不能提供确切的证据，颅内电极记录是确定致痫灶的可靠方法。

Objective For patients with lesional lateral temporal lobe epilepsy, whether or not to resection the hippocampal is difficult to decide. We analyzed the intracranial EEG of patients with localized lesion in the lateral temporalcortex. Methods We studied 8 patients who satisfied the following criteria： MRI showed a lesion localized at the lateral temporal lobe. Postoperative follow -up was more than 1 year. Results A total of 65 complex partial seizures and 16 subclinical seizures were recorded, among them, 24 clinical seizures and 7 subclinical seizures arising from hippoeampal. 7 patients had ietal discharges originating from the hippoeampal. Conclusions Intracranial EEG analysis revealed that independent ictal discharges from the bippocampal in patients with localized lesion in the lateral cortex, hippocampal maybe an independent epilepticgenic onset zone.