视频脑电图监测联合蝶骨电极描记对颞叶内侧癫痫及新皮层癫痫患者发作起源定位的意义

The value of video EEG monitoring combined with sphenoid electrode in locating the origin of seizure onset in patients with medial temporal lobe epilepsy and patients with neocortex epilepsy

目的探讨视频脑电图(V-EEG)监测联合蝶骨电极描记对颞叶内侧癫痫及新皮层癫痫患者发作起源定位的意义。方法选取海南医学院第二附属医院2010年4月至2022年10月确诊为局灶性癫痫的患者58例,所有患者均行V-EEG监测联合蝶骨电极描记和常规脑电图(REEG)检查,并对颞叶内侧癫痫及新皮层癫痫患者的V-EEG监测联合蝶骨电极描记与REEG的痫样放电阳性率进行比较。通过V-EEG联合蝶骨电极描记对不同类型局灶性癫痫起源的特点进行分析。并比较V-EEG联合蝶骨电极描记确定的癫痫起源与MRI检查的一致性。结果局灶性癫痫患者V-EEG联合蝶骨电极描记的痫样放电阳性率高于REEG(P<0.05);颞叶内侧癫痫患者V-EEG联合蝶骨电极描记的阳性率高于新皮层癫痫(P<0.05);不同类型癫痫发作起源的V-EEG表现各不相同。结论V-EEG联合蝶骨电极对颞叶内侧癫痫患者的诊断阳性率高于新皮层癫痫。不同部位的局灶性癫痫发作起源的V-EEG表现不同。

Objective To investigate the values of video EEG(V-EEG)combined with sphenoid electrode in locating the origin of medial temporal lobe epilepsy and neocortex epilepsy.Methods From April 2010 to October 2022,58 patients diagnosed as focal epilepsy in the Second Affiliated Hospital of Hainan Medical College were selected.All patients were given V-EEG combine with sphenoid electrode and REEG.The positive rates of epileptiform discharges in the patients with medial temporal lobe epilepsy and the patients with neocortical epilepsy were compared between V-EEG plus sphenoid electrode and REEG.The origin characteristics of different types of focal epilepsy were analyzed by V-EEG plus sphenoid electrode.The consistency of detected epilepsy origins was compared between V-EEG plus sphenoid electrode and MRI.Results The positive rate of epileptiform discharge detected by V-EEG plus sphenoid electrode was higher than that by REEG in patients with lobe epilepsy(P<0.05).The positive rate of epileptiform discharge detected by V-EEG combine with sphenoid electrode was higher in medial temporal lobe epilepsy than that in neocortex epilepsy(P<0.05).V-EEG manifestations of different types of seizure origins were different.Conclusion The positive rate of epileptiform discharge diagnosed by V-EEG plus sphenoid electrode was higher in medial temporal lobe epilepsy than that of neocortex epilepsy.V-EEG manifestations of focal seizure origins in different parts are different.