术中体感诱发电位在切除中央沟附近癫痫病灶中的应用  

Analysis on application of somatosensory evoked potential in the operation of epilepsy

作　　者：梁秦川[1] 井晓荣[1] 王超[1] 张华[1] 高国栋[1] 

机构地区：[1]第四军医大学唐都医院神经外科,西安710038

出　　处：《立体定向和功能性神经外科杂志》2009年第2期75-77,共3页Chinese Journal of Stereotactic and Functional Neurosurgery

基　　金：国家自然科学基金资助项目(编号:30772221)

摘　　要：目的探讨术中皮层体感诱发电位(cortical somatosensory evoked potential,CSEP)在切除脑中央沟附近致痫灶中的应用意义。方法28例难治性癫痫患者,术中采用肌电/诱发电位仪,刺激癫痫灶所在运动区所支配对侧上肢的正中神经,使用条状皮层电极于该侧拟确定的中央沟前后的皮层进行CSEP记录。依据中央沟前后的皮层所记录到的上肢CSEP具有极性倒转的特性,进行中央沟定位。在皮层脑电图监测下进行致痫灶切除,术后常规应用抗癫痫药物。结果术后疗效评价,按照Engel分级评价为:I级19例,II级4例,III级3例,IV级2例;总有效者26例,有效率达92.9%。结论术中CSEP是一种简单可靠的准确定位中央沟方法,有助于提高手术治疗的安全性,在癫痫外科治疗中具有一定的应用价值。Objective To investigate the method of intraoperative mapping of eloquent areas by somatosensory evoked potential in surgery of the epileptogenic zone near the central sulcus. Methods Somatosensory evoked potential was used on 28 patients with intractable epilepsy for accurate localization of the central sulcus. Then the epileptogenic focus was removed by using extended ectomy according ECoG records. Antiepileptic drugs were used after operation. Results According to curative effect assessment of Engel, the clinical outcome showed that 19 patients were seizure free after surgery,7 patients were improved, and 2 patients were not improved. The effective rate was 92.9% （26/28）. Conclusion It is a reliable,precise and safe method that intraoperative mapping of central sulcus by somatosensory evoked potential, which allow a maximum resection of epileptogenic zone and protection of brain function.

关 键 词：难治性癫痫 中央沟 体感诱发电位 手术 

分 类 号：R742.1[医药卫生—神经病学与精神病学]