联合应用电生理技术对癫痫灶精确定位的研究

The Combination of EEG Methods to Localize Epileptogenic Foci

目的:联合应用多种电生理技术(EEG)对痫灶进行定位。方法:运用多种EEG技术对50例癫痫患者行痫灶定位,并与各种神经影像学检查方法进行比较。定位明确患者行手术治疗,标本行光镜及透射电镜检查,治疗结果以Engel疗效分级评价。结果:使用EEG技术对痫灶定位,其准确率为83.3％,以EEG技术为基础,并与神经影像学方法联合应用,痫灶定位准确率则达到100％。具有EEG异常的癫痫患者,痫灶必然伴有相应病理性损害。结论:反复、多次视频脑电(VEEG)监测,是痫灶定位的首选方法。多种类型的EEG在不同的时段进行监测,是高效、经济、安全无创,可明显提高癫痫灶的检出率及定位的准确性,提高手术疗效。

Objective: To evaluate the diagnostic value of the combination of EEG methods in localization of epileptogenic foci. Methods: The clinical research reviewed the results of fifty epileptic patients (21 M, 29 F,av. 22. 3y) on reoutine EEG (REEG), Video-EEG( VEEG) , twenty-four hour active EEG (AEEG) , CTI MRI( including fMRI、MRS) scanning and SPECT, MEG and PTE examination. All the results of these modalities were compared with each other and the relationship between epileptic discharges of EEG and lesions of CT、MRI and SPECT was analyxed by using x2 test. 30 patients who underwent surgery were followed up (av. 13 months,3-22 months) for assessment of seizure control. Results: The highest positive rate of epileptic foci(83. 3% ) was found in EEG. The positive rate of combination of EEG methods and neuroimaging techonolgies was perfectly 100. 0%. Conclusions: The number of localization epileptic foci was significantly different between EEG results and neuroimaging techniques. EE is still a sensitive and effective method for epileptiform foci localization. EEG may have the advantage in detecting and localizing epileptic foci of MRI, CT, and SPECT. Combination of EEG technologies will improve the positive rate of epileptogenic area, which is useful for the precise diagnosis of epileptic focus and it may offer probable pathologic diagnosis for partial epilepsy, which is of great clinical significance.