颅脑手术前后继发性癫痫的动态脑电图监测

Monitoring Dynamic EEC of Secondary Epilepsy before and after Intracranial Surgery

目的 了解颅脑手术前后继发性癫痫的动态脑电图表现特点及其与手术的关系。方法 选择290例颅内占位性疾病患者,术前1～3d及术后1周、1～3月分别观察其EEG表现。结果 术前有癫痫发作(A组)128例,EEG示痫样放电者117例,痫波检出率为91.4％。术后97例无临床发作,有效率为75.8％;术前无癫痫发作(B组)162例,EEG可见痫样放电者24例。术后新发癫痫19例,均可见痫样放电。结论 开颅手术是治疗继发性癫痫的有效手段,但也可能是导致继发性癫痫的原因之一。

Objective To study the dynamic EEG features of secondary epilepsy before and after intracranial surgery and the relationship between it and operation. Methods In 290 patients with intracranial mass lesions diagnosed by CT or MRI, dynamic EEG was recorded during 1-3 days before surgery as well as 1 week and 1-3 months after the surgery. Results Of 128 patients who had clinical seizures before the surgery, 117 (91.4%) had epileptiform discharges showed by EEG and 97 (75.8%) didn't suffer from clinical seizures after the surgery. Of 162 patients who had no clinical seizures before the surgery, 24 had preoperation epileptiform discharges showed by EEG and 19 developed symptomatic seizures and had epileptifrom discharge showed by EEG after the surgery. Conclusions On the one hand the intracranial surgery is an effective method to treat the secondary seizures, on the other hand it possiblly causes seizures in the patients with intracranial mass lesions.