头皮动态脑电图在合并癫痫的老年颅内幕上肿瘤患者中的表现

Characteristics of ambulatory electroencephalogram in the elderly patients with supratentorial tumor complicated with epileptics

目的探讨头皮动态脑电图(AEEG)在以癫痫为主要症状的老年颅内幕上肿瘤患者中的表现特点及临床价值。方法选择103例合并有癫痫症状的老年颅内幕上肿瘤患者临床资料,所有患者术前至少做1次AEEG检查,术中行皮层脑电图(ECo G)检查;比较两者异常放电波形特点、异常放电的病灶位置分布。结果所有患者术中异常放电阳性率为100.00%,AEEG显示有86例(83.50%)出现异常放电,其中ECo GⅠ型脑电波阳性率显著低于AEEG,ECo GⅤ型脑电波阳性率显著高于AEEG(P<0.05),2种方法Ⅱ型、Ⅲ型、Ⅳ型脑电波阳性率比较差异无统计学意义(P>0.05)。术前检查显示额叶、颞叶、顶叶间无异常放电阳性率、非局限型放电阳性率比较差异无统计学意义(P>0.05),额叶局限型放电率显著高于颞叶、顶叶(P<0.05)。术中额叶广泛性异常放电率显著高于颞叶和顶叶,额叶局限性异常放电率显著低于颞叶和顶叶(P<0.05)。结论合并有癫痫症状的老年颅内幕上肿瘤患者AEEG检查异常放电阳性率低于ECo G,但AEEG与ECo G有部分一致性,术前AEEG检测能够为手术方案的制定提供一定依据。

Objective To explore the characteristics of ambulatory electroencephalogram（ AEEG） in the elderly patients with supratentorial tumor complicated with epileptics. Methods A total of 103 cases of supratentorial tumor complicated with epileptics were enrolled in this study. The clinical data were analyzed. All patients underwent at least 1time of AEEG examination before operation,and cortical electroencephalogram（ ECo G） examination during operation. The characteristics of abnormal discharge and the location distribution of the lesion were compared. Results The positive rate of abnormal discharge during operation was 100. 00%,compared with 83. 50% before operation. The positive rate of type Ⅰbrain wave in ECo G was significantly lower than that in AEEG,while the positive rate of type V brain wave was significantly higher than that in AEEG（ P〈0. 05）. TypeⅡ,typeⅢ,type Ⅳ brain wave showed no significant differences between two examination methods（ P〉0. 05）. Before operation AEEG showed that non abnormal discharge rate,non localized type discharge rate showed no statistical significance difference between frontal lobe,temporal lobe and parietal lobe（ P〈0. 05）.Localized discharge rate in frontal lobe was significantly higher than that in the temporal lobe,parietal lobe（ P〈0. 05）.During operation,ECo G examination showed that the discharge rate in frontal lobe was significantly higher than that in temporal lobe and the parietal lobe,and the discharge rate of the frontal limitation was significantly lower than that of the temporal lobe and the parietal lobe（ P〈0. 05）. Conclusions The positive rate of abnormal discharge in preoperative AEEG is lower than ECo G in the elderly patients with supratentorial tumor complicated with epileptics,and AEEG examination can provide suggestion for surgical plan.