高频脑磁图技术在难治性颞叶癫痫手术治疗中的应用

High frequency magnetoencephalographic signals in surgery of refractory temporal lobe epilepsy

目的探讨应用高频脑磁图定位颞叶癫痫灶对癫痫外科手术的指导价值。方法选择广东三九脑科医院神经外六科自2015年1月至2015年12月采用手术治疗的难治性颞叶癫痫患者10例，术前均根据MRI、长程视频脑电图（VEEG）、常规及高频脑磁图（MEG）技术定位癫痫灶、确定手术方式．术后对患者的MEG数据进行高频MEG分析定位，术后12个月随访患者确定手术疗效。结果10例患者手术均有效，其中Engel分级Ⅰ级5例，Ⅱ级2例，Ⅲ级3例。高频MEG分析定位结果中有8例定位结果与手术部位一致，且手术有效；2例患者定位误差较大。结论高频MEG信号分析具有定位癫痫灶的作用，可为癫痫灶的切除或毁损提供依据。

Objective To investigate the value of high frequency magnetoencephalography signals in the localization of refractory temporal lobe epilepsy. Methods Retrospective analysis was performed in 10 patients with refractory temporal lobe epilepsy admitted to and accepted surgery in our hospital from January 2015 to December 2015. Surgical approaches of these patients were determined according to the results of long-term video EEG monitoring （VEEG）, MR imaging, and conventional and high-frequency magnetoencephalography （MEG）. MEG positioning analysis was performed after the surgery; followed up for 12 months was performed to evaluate the surgical efficacies. Results The surgery was effective in all the 10 patients; 5 patients achieved Engel grading I, 2 patients achieved Engel grading II, and 3 patients achieved Engel grading III. The results of high-frequency MEG analysis indicated that 8 lesions were consistent with the surgical sites, enjoying good results; while the positioning error of the 2 patients was large. Conclusions The localization analysis of high-fi＇equency neuromagnetic signals has the potential to determine epileptogenic zones preoperatively for epilepsy surgery. High-frequency oscillation is a new biomarker for the diagnosis of epilepsy.