磁共振阴性的局灶性脑皮质发育不良的手术治疗  

Surgical treatment for negative MRI epileptogenic focal cortical dysplasia

作　　者：朱劲龙 李嘉佳[1] 朱海涛[1] 朱旭昌 张锐[1] 

机构地区：[1]南京医科大学附属脑科医院神经外科,210029

出　　处：《临床神经外科杂志》2014年第6期412-415,共4页Journal of Clinical Neurosurgery

基　　金：江苏省自然科学基金项目(BK20131081)

摘　　要：目的：探讨磁共振难以确定病灶的致痫性局灶性脑皮质发育不良的诊断和定位方法，提高手术治疗效果。方法回顾性分析联合应用视频脑电图（VEEG）、脑磁图（MEG）及术中皮层电极脑电图监测（ ECoG）检查，诊断、定位并经手术后病理证实为局灶性皮质发育不良（ FCD）的24例磁共振检查阴性的难治性癫痫患者的临床资料。结果24例癫痫患者行手术治疗，病理FCD Ⅰa型5例，FCD Ⅰb型3例，FCD Ⅰc型5例，FCDⅡa型6例， FCDⅡb型5例。术后随访1～5年，EngelⅠ级9例，Engel Ⅱ级5例，Engel Ⅲ级8例，EngelⅣ级2例。结论联合应用VEEG、MEG和（或） ECoG技术有助于准确诊断和定位磁共振阴性的FCD，提高FCD致难治性癫痫的手术疗效。Objective To investigate the method of diagnosis and localization for negative magnetic resonance imaging （ MRI ） focal cortical dysplasia （ FCD ） , and improve the effects of surgical treatment.Methods The clinical data of 24 patients with diagnosis and localization for negative MRI FCD by video electroencephalogram（VEEG）,magnetoen-eephalography （MEG） and intraoperative electrocorticography （ ECoG ） , and FCD were proved by operation, were analyzed retrospectively.Results 24 patients of epilepsy treated by the operation and pathological reports showed 5 cases of FCD typeⅠa,3 FCD typeⅠb,5 FCD typeⅠc,6 FCD typeⅡa and 5 FCD typeⅡb.The follow up from 1 to 5 years showed Engel Ⅰgrade in 9 cases,Engel Ⅱgrade in 5,EngelⅢgrade in 8 and EngelⅣgrade in 2.Conclusion Combined application of VEEG,MEG and （ or） ECoG technology can accurately diagnose and location for negative MRI FCD, and Increase the operative efficacy of epileptogenic FCD.

关 键 词：癫痫 局灶性皮质发育不良 外科治疗 视频脑电图 脑磁图 

分 类 号：R749.1[医药卫生—神经病学与精神病学]