后放电监测在术中皮层电刺激脑皮层功能区识别中的意义

Value of afterdischarges monitoring for intraoperative electrical stimulation for brain mapping

目的:探讨后放电监测在术中皮层电刺激脑皮层功能区识别中的意义。方法:34例涉及脑功能区病变切除手术的患者,术中皮层电刺激识别脑皮层功能区,同时持续监测皮层脑电,以出现后放电的阈值作为电刺激强度的上限,或最大电流量达到20 mA为止。结果:34例患者均顺利完成了术中皮层电刺激识别脑皮层功能区,无不良反应;均进行了病灶切除术,除2例病灶与运动功能区或运动前区重叠、术后出现对侧肢体运动功能减退外,其他病例术后均未出现神经功能下降。结论:在术中皮层电刺激脑皮层功能区识别中监测后放电,可提高皮层电刺激的阳性率,降低假阴性率,降低电刺激的风险。

Objective To explore the value of afterdischarges stimulation for brain mapping. Methods 34 patients received cerebral monitoring for intraoperative electrical cortex electrical stimulation for brain mapping during operation of brain function area, afterdiseharges were monitored simultaneously to determine the upper limit of stimulus intensity. Results 34 cases underwent electrical stimulation successfully, and received surgery without neurologic decline except 2 cases of hypokinesia. Conclusion After discharges monitoring improve the accuracy, reduce the risk of intraoperative cerebral cortex electrical stimulation.