颞叶内侧及外侧癫痫蝶骨电极长程视频脑电图监测  

Analysis for application of continual sphenoidal electrodes video electroencephalogram in diagnose and localization of medial temporal lobe epilepsy and necortical temporal lobe epilepsy

作　　者：井晓荣[1] 梁秦川[1] 王超[1] 郭恒[1] 游宇[1] 徐敏[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,全军功能性神经外科研究所,陕西西安710038

出　　处：《癫痫与神经电生理学杂志》2010年第1期13-17,共5页Journal of Epileptology and Electroneurophysiology(China)

基　　金：受国家自然科学基金资助（项目编号30772221）

摘　　要：目的：比较颞叶内侧癫痫（MTLE）及颞叶外侧癫痫（颞叶新皮层癫痫，NCTLE）蝶骨电极长程视频脑电（V-EEG）的特点。方法：根据国际抗癫痫联盟（ILAE）癫痫综合征的诊断标准，从发作类型、临床特征以及解剖部位、病因等方面，将112例难治性颞叶癫痫分为MTLE89例，NCTLE23例，对其蝶骨电极长程V—EEG监测结果进行回顾分析。结果：MTLE组和NCTLE组均具有高先兆出现率，蝶骨电极发作间期EEG棘波、棘慢波、尖波、尖慢波总检出率分别为83．1％和30．4％，其间差异具有显著意义（P〈0．01）。发作期蝶骨电极EEG定位准确率较高，MTLE定侧率为70．8％（63／89），临床发作形式以手口自动症为主。结论：MTLE与NCTLE具有相应EEG及临床发作特征，蝶骨电极长程V—EEG监测能有效鉴别诊断MTLE与NCTLE，在一定程度上可为准确定位致痫灶提供可靠依据，进而有利于指导手术。Objective：To analyse and compare the feafures of sphenoidat electrodes long term video electroencephalogram of medial temporal lobe epilepsy（MTLE） and necortical temporal lobe epilepsy （NCTLE）. Methods： One hundred and twelve patients with temporal lobe epilepsy（TLE） were divided into 89 cases with medial TLE （MTLE） and 23 cases with necortical TLE（NCTLE） two groups according to the Intermational League of Antiepilepsy （ILAE） ,then analyzed in their long term sphenoidal electrode video-EEG monitoning. Results： High appearance rate of aure was found in the two groups;The detectable rate of epileptic discharge was 83.1% in MTLE patients and 30.4% in NCTLE patients,show ing significant difference between the two groups （P〈0.005）. The side of epileptogenic foci determined by sphenoidal electrodes neaehed a rate of 70.8% （63/89） in MTLE patients;hand and mouth automa tisms are the primary seisure forms in MTLE patients. Conclusion： MTLE and NCTLE have correspond ing characteristics on EEG and seisure forms. Continual sphenoidal electrodes monitoring can differentiate MTLE and NCTLE, and it can supply credible evidanee for the localization of epileptogenie foci accurately and direct epilepsy operations effectively.

关 键 词：颞叶内侧癫痫(MTLE) 颞叶外侧癫痫(NCTLE) 视频脑电图(V-EEG) 蝶骨电极 

分 类 号：R742.1[医药卫生—神经病学与精神病学] R741.044[医药卫生—临床医学]