皮质脑电图在脑海绵状血管瘤所致癫痫手术中的应用研究  

Study of application of electrocorticography in surgical operation of epilepsy caused by brain cavernous angioma

作　　者：钱苏荣[1] 肖其华[1] 王晨[1] 吴建东[1] 黄思庆 

机构地区：[1]苏州市立医院北区神经外科 [2]四川大学华西医院神经外科

出　　处：《临床神经病学杂志》2013年第3期210-212,共3页Journal of Clinical Neurology

摘　　要：目的研究皮质脑电图(ECoG)在脑海绵状血管瘤(BCA)所致癫痫手术中的作用。方法对经正规抗癫痫治疗无效的85例BCA致癫痫患者,在ECoG监测下进行致痫灶定位,指导手术治疗。术后对患者进行随访及疗效评定。结果术中ECoG监测发现本组患者的BCA病变区均存在棘波发放,而术前头皮EEG仅56例存在棘波,术中ECoG还发现31例患者有新的致痫灶。所有患者在ECoG监测下进行致痫灶切除(非功能区)或低功率热灼术(功能区)。术后平均随访3.4年,疗效满意(癫痫发作完全消失)61例(71.8%),良好(发作减少≥50%)18例(21.2%),差(发作减少<50%)6例(7.1%);总有效(满意+良好)率92.9%。结论 ECoG监测可在BCA所致癫痫手术中准确定位致痫灶,明显提高手术的疗效。Objective To investigate the effects of electrocorticography （ECoG） in surgical operation of epilepsy caused by brain cavernous angioma （BCA）. Methods The 85 epileptogenic BCA patients were located epileptogenic focusi with ECoG monitoring,to guide the operation treatment. Follow-up and curative effect evaluation of patients were performed after the operation. Results The dissemination of spike waves all patients were found with ECoG monitoring durin operation, and only 56 cases showed spike waves at preoperative scalp EEG examination. The intraoperative ECoG also found new epileptogenic focus in 31 cases. All patients were conducted epileptogenic zone resection （non-functional area） or low power hot burning operation （functional area） under the ECoG monitoring. The average follow-up period was 3.4 years after the operation. The 61 cases （71.8%） were effects satisfaction （ epilepsy seizure free） , 18 cases （ 21.2% ） were effective （ seizure reduced ~〉 50% ） , 6 cases （ 7.1% ） were not fine （seizure reduced 〈 50% ） ; The rate of total efficiency （ satisfaction ＋ effective） was 92.9%. Conclusion ECoG monitoring can accurately localized epileptogenic focus in the operation of epilepsy caused by BCA, significantly improve the curative effect of the operation.

关 键 词：脑海绵状血管瘤 癫痫 皮质脑电图 手术治疗 

分 类 号：R742.1[医药卫生—神经病学与精神病学]