难治性癫痫中局灶性脑皮质发育不良类型与头皮脑电图的关系  

The relationship between the pathological types and scalp electroencephalography features in patientswith focal cortical dysplasia and intractable epilepsy

作　　者：陈述花[1] 张冰清[1] 王静[1] 刘兴洲[1] 栾国明[1] 张玮[1] 王海祥[1] 

机构地区：[1]北京三博脑科医院首都医科大学第十一临床学院,北京100093

出　　处：《中华神经外科杂志》2013年第12期1216-1219,共4页Chinese Journal of Neurosurgery

基　　金：北京市科委“首都l临床特色应用研究”（Z111107058811011）;北京市自然科学基金项目（7122088）

摘　　要：目的研究难治性癫痫患者中局灶性脑皮质发育不良（FCD）不同病理学类型与头皮脑电图（EEG）癫痫样放电形态之间的关系。方法选择术后病理学证实为FCD的难治性癫痫患者9l例，头皮EEG间歇期癫痫样放电形态分为无癫痫样放电、棘波、多棘波和快节律四型。发作起始区EEG形态分为棘波、多棘波和（或）快节律、电位低减和不能分型四型。结果不同FCD类型头皮EEG间歇期癫痫样放电形态比较差异有统计学意义（P=0．013），其中FCDlIa和FCDIIb中多棘波多见；FCDⅡa中快节律多见，FCDI和FCDⅢ中棘波多见。但发作起始区EEG形态与FCD类型无关（P=0．1976）。结论FCD所致的难治性癫痫中，FCD类型可能与头皮EEG间歇期癫痫样放电形态有关，对EEG癫痫样放电形态的分析可能会为FCD所致难治性癫痫的手术治疗提供依据。。Objectiv]e To study the relationship between different pathological types of focal cortical dysplasia （FCD） and the morphology of epileptiform discharges on electroencephalography （EEG） in patients with intractable epilepsy. Methods Case series of 91 patients （ male ： female = 54 ： 37 ）, aged 12. 7 ± 9.76 years, with histo - pathological diagnosis of FCD （ based on the consensus classification proposed by an ad hoc Task Force of the ILAE Diagnostic Methods Commission）. All patients were examined by long - term scalp video EEG monitoring before operation and were followed up at least 6 months after operation. The morphology of the interictal discharges on scalp EEG were divided into 4 types including no epileptiform discharges, spikes, poly - spikes and fast rhythms. The morphology of the seizure onset was also divided into 4 types including spikes, poly - spikes and/or fast rhythms, electro - decremental and unclassified. Results Of 91 patients, there were significant difference between different types of FCD in the morphology of interictal discharges （ P = 0. 013） with polyspikes more common in FCD Ⅰ a and FCD Ⅱ b and fast rhythms more common in FCD H a and spikes more common in FCD I and FCD m. But no relationship was found between the morphology of the seizure onset and FCD types （ P = 0. 1976 ） . Conclusions In patients with FCD and intractable epilepsy, the morphology of interictal discharges in scalp EEG is probably related to the pathological types of FCD.

关 键 词：局灶性脑皮质发育不良 难治性癫痫 脑电图 形态 

分 类 号：R742.1[医药卫生—神经病学与精神病学]