症状性癫痫致痫灶的精确定位结果与微创手术疗效分析  

Results for precise localization of epileptogenic foci of symptomatic epilepsy and efficacy analysis of minimally invasive surgery

作　　者：张新伟[1] 徐如祥[1] 周谷兰[1] 张冉[1] 

机构地区：[1]南方医科大学珠江医院神经外科,广州510282

出　　处：《中华神经医学杂志》2007年第10期1027-1030,共4页Chinese Journal of Neuromedicine

摘　　要：目的探讨症状性癫痫患者致痫灶电生理学、MR检查精确定位结果与微创外科手术疗效。方法分析2004年9月～2006年3月经我院诊治且资料完整的91例症状性癫痫患者的临床资料及术后随访情况,分析电生理学与MR检查的精确性,评定手术效果。结果电生理检查与MR检查比较,MR检查漏诊率高,而精确度较好,电生理检查漏诊率低,但误诊率高,精确度差。本组手术满意率为96.70%。结论本组病例应用综合精确定位技术进行致痫灶定位是可靠的。电生理检查结果可以作为判断致痫灶位置的参考指标,但在缺乏影像学检查支持时,并不足以成为判断致痫灶位置的确定指标。提高MR扫描的分辨率,降低MR漏诊率是必要的。Objective To explore the veracity of localization of epileptogenic foci by the electrophysiological examination and MR scan and effects of minimally invasive surgery in patients with symptomatic epilepsy. Methods The clinical data and postoperative follow-up observations of 91 cases with symptomatic epilepsy were analyzed; these patients had undergone therapies for the treatment of their epilepsy in our hospital during Sep., 2004 and Mar., 2006 and their medical records were kept intact. The electrophysiological and MR findings for the veracity of localization were also analyzed and surgical effects were evaluated. Results The comparison between the electrophysiological examination and MR scan found that, the latter had a high rate of missed diagnosis but favorable veracity and the former had a low rate of missed diagnosis but a high rate ofmisdiagnosis and poor veracity. The satisfactory rate in this study was 96.70%. Conclusion The integrated techniques for precise localization of epileptogenic foci are reliable. Results of the electrophysiological examination can be regarded as the index for reference in judging the site of the epileptogenic focus, but without the assistance of imaging examination, these results cannot be considered as the assured index. Therefore, it is necessary to raise the resolution of MR scan to cut down the rate of missed diagnosis by MR scan.

关 键 词：症状性癫痫 电生理学检查 MR检查 

分 类 号：R742.1[医药卫生—神经病学与精神病学]