颅内电极皮层电刺激后放电的产生规律研究

The study of after-discharges（AD） caused by electrical cortical stimulation

目的：通过对后放电（AD）产生规律的研究，尽可能在临床皮层电刺激过程中减少AD的发生，优化皮层电刺激流程。方法：回顾性研究2011-2012年在我科行癫痫颅内电极埋置术并接受皮层电刺激患者的脑电图（EEG）资料共10例，对皮层AD的产生规律进行分析。结果：统计10例出现皮层AD的病人，产生的AD位于127个点，频率从1-12Hz不等，各种AD中以尖、棘慢波为主（46％），其次为重复性尖波（39％），节律性正弦波（9％），多棘波（6％）。AD的出现阈值与运动、感觉阈值存在明显差异，而与语言阈值无明显差异。结论：癫痫患者皮层电刺激过程中可诱导AD的发生，一旦出现则有较高的重复率，而且部位刺激相对固定。AD出现位置与脑叶位置无关，但如果在不同部位刺激而固定在某一点反复出现AD，则可能提示该点与致痫灶关系密切。

Objective To study the characteristics of after--discharges（AD）so as to minimize the occurrence of AD in the clinical use of electronic cortical stimulation （ECS） and optimize the process of the stimulation. Methods.. A retrospective analysis of EEG data were made from patients with epilepsy who underwent intracranial electrodes surgery and ECS. Results..127 points of electrodes were located in 10 cases with AD with the frequency from 1 to 12 Hz. The patterns included spike waves （46.1%）, re petitive spikes （38.5%）, rhythmic waves （9%）, and poly-spikes （6.4%）. The results showed statistically significant difference between AD and sensorimotor functions, which did not occur in linguistic function. Conclsion.-ECS to patients with epilepsy can induce AD. Once it is made, the repetition rate is high and the positions of stimulation are relatively fixed. AD positions have no relation with lobar location, but if AD occurs at the same point repeatedly when stimulus are made at different points that indicate that this position may be closely related with epileptogenic loci.