难治性癫痫三级脑电监测及显微手术干预30例疗效观察  

Assessment of three-level electroencephalography monitor and microsurgery for intractable epilepsy:analysis of 30 cases

作　　者：蓝胜勇[1] 肖泉[1] 徐鹏[1] 梁娟铭[1] 叶劲[1] 刘若平[1] 唐秀文[1] 庞刚[1] 钟书[1] 梁有明[1] 徐柯贝[1] 曾令华[1] 

机构地区：[1]广西壮族自治区人民医院神经外科,南宁530021

出　　处：《中国临床新医学》2013年第6期529-531,共3页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

基　　金：广西卫生厅科研课题(编号:Z2012283)

摘　　要：目的探讨难治性癫痫三级脑电监测及显微手术干预的临床效果。方法对30例难治性癫痫患者进行常规头皮脑电图(EEG)和动态视频脑电图(VEEG)监测,结合CT、MRI、ECT影像表现,进行综合性评估,确定致痫灶;术中皮层脑电图(ECoG)及深部电极脑电图(DEEG)监测癫痫放电区域,麻醉唤醒后,皮层及深部电刺激验证,对孤立性癫痫病灶行显微手术切除,对多灶性或双侧独立的癫痫灶行胼胝体切开术,对位于皮质功能区癫痫灶行软脑膜下横切(MST)。结果 30例难治性癫痫患者术后Engel分级:Ⅰ级19例,Ⅱ级10例,Ⅲ级1例,无Ⅳ级病例。所有患者术后无永久性神经功能缺失,无语言记忆功能障碍。结论 VEEG+MRI+ECT+ECoG或DEEG组合评估,对难治性癫痫致痫灶定位准确,显微手术后疗效良好。Objective To discuss the clinical improvement of three-level electroencephalography monitor and microsurgery for intractable epilepsy. Methods Thirty intractable epilepsy patients were comprehensively evaluated by combining electroencephalography（EEG）/videoelectroencephalography（VEEG） with imaging finding of computer tomography （ CT ）/magnetic resonance imaging （MRI）/emission computed tomography （ ECT ）, then, the epileptic fo- cus were located, finally, epileptic discharge area were checked by electrocorticalgram（ ECoG）/depth electroenceph- alography（DEEG） and conformed ECoG and DEEG during wake up test. Microsurgical resection were performed for isolated epileptic focus, corpus caUosotomy were performed for muhifocal or bilateral independent epileptic foci, mul- tiple subpial transectio（MST） were performed for epileptic foci included cortical functional areas. Results Postoper- ative Engel grade：Ⅰ 19 cases, Ⅱ 10 cases, Ⅲ 1 case,Ⅳ none. There is on permanent nerve function loss reduc- tion in those cases. Conclusion Combining VEEG/MRI/ECT and ECoG（ or DEEG）, the epileptic focus of intracta- ble epilepsy were accurately located, and satisfactory post-operation outcomes were achieved.

关 键 词：头皮脑电图 动态视频脑电图 皮层脑电图 深部电极脑电图 显微手术 

分 类 号：R741[医药卫生—神经病学与精神病学]