颞叶神经节胶质细胞瘤患者脑电图特点分析

features of temporal lobe ganglion gliomas

目的总结颞叶神经节胶质细胞瘤（GG）患者的脑电图特点，探讨脑电图监测在颞叶GG诊疗中的作用。方法河北省人民医院神经外科自2008年9月至2015年9月收治24例颞叶GG患者，回顾性分析患者的临床特点、诊断及治疗经过，重点研究患者的脑电图资料。结果发作间期脑电图显示：在病灶以外脑区及对侧脑区异常放电者17例（70．8％）。发作期脑电图显示：能够明确一侧颞蝶骨起源的10例（41．6％）。术中脑电图显示：22例（91．7％）颞叶内侧有低波幅快波夹杂高波幅尖波或棘波；23例（95．8％）颞叶皮层有高波幅尖波或棘波；患者术后随访1～8年，Engel’s分级Ⅰ级19例（79％）。其中11例患者术后3年无发作，已逐渐减停抗癫痫药物。Engel’s分级Ⅱ级5例。均继续应用抗癫痫药物治疗。结论颞叶GG患者的脑电图显示异常放电活动多以尖慢波为主．容易泛化至其他脑区及对侧。术中脑电监测在GG中心和周围均可记录到异常放电。以连续性棘波节律多见，皮层及深部电极监测可以帮助确定病灶及周围致痫区的范围，指导手术，降低癫痫的发作。

Objective To summary the electroencephalography characteristics of temporal lobe ganglion glioma （GG）, and explore the role of electroencephalogram in diagnosis and treatment of temporal lobe GG. Methods Retrospective analysis of clinical features, diagnosis and treatment of 24 patients with temporal lobe GG, admitted to our hospital from September 2008 to September 2015, was performed. The temporal lobe GG electroencephalography features were accepted focused research. Results Break electroencephalography showed that： abnormal discharge of lesions in store area and contralateral brain regions was noted in 17 patients （70.8%）. Episodes electroencephalography showed that： 10 patients （41.6%） could be conformed that discharge was originated from the side of temporal sphenoid. Intra-operative electroencephalography showed that the medial temporal lobe in 22 patients （91.7%） had low amplitude fast wave with high reflection of sharp wave or spike wave; the temporal lobe cortex in 23 patients （95.8%） had high reflection of sharp wave or spike wave. The patients were followed up for one to 8 years. Engel＇s grading Ⅰ was noted in 19 patients （79%）, including 11 gradually stopped taking antiepileptic drugs after three years of free seizure; Engel＇ s grading Ⅱ was noted in 5 patients （79%）, and antiepileptic drugs were taken. Conclusions The temporal lobe GG electroencephalography shows that abnormal discharge is sharp and slow waves are noted, which are easy to generalize to other brain regions and the contralateral side. Monitoring of electroencephalography during operation can record the abnormal discharge around and in the center of GG with spike wave rhythms. Cortical electroencephalogram and deep electrode monitoring can help to determine the lesion and the around range of epilepsy, which can guide the operation and improve the control of seizures.