Sturge—Weber综合征伴发癫痫的脑磁图及磁源成像的研究  

Magnetoencephalography and magnetic source imaging studies for epilepsy associated with Sturge-Weber syndrome

作　　者：张萍[1] 刘慧娟 滕鹏飞 栾国明[2] 王静[3] 马敬轩 

机构地区：[1]首都医科大学三博脑科医院脑磁图中心,北京100093 [2]首都医科大学三博脑科医院神经外科,北京100093 [3]首都医科大学三博脑科医院电生理中心,北京100093

出　　处：《中华神经外科杂志》2017年第9期927-930,共4页Chinese Journal of Neurosurgery

摘　　要：目的探讨Sturge—Weber综合征（SWS）伴发癫痫患者的脑磁图特点、影响脑磁图定位的可能因素及临床应用价值。方法回顾性分析2010年10月至2016年6月在首都医科大学三博脑科医院收治的14例SWS伴发癫痫患者的脑磁图资料，并对患者术前的头颅MRI、视频脑电图和脑磁图结果进行比较。结果14例脑磁图检查中8例有一侧背景活动减弱；11例采集到癫痫样放电，其中9例磁源成像显示癫痫灶位于颅内病变（血管瘤）同侧半球（右侧6例，左侧3例），2例在双侧半球。14例中有9例发作间歇期脑电图与脑磁图均记录到癫痫样放电，2例脑磁图采集到癫痫样放电而脑电图未记录到，1例脑电图记录到癫痫样放电而脑磁图未记录到，2例脑电图与脑磁图均未记录到癫痫样放电。结论SWS发作间期的脑磁图与脑电图有着相类似的表现，主要为颅内病变受累一侧背景活动的减弱；癫痫样放电多为颅内受累病变的同侧，少数可见于双侧或受累的对侧。脑磁图与磁共振融合形成的磁源成像技术有助于定位SWS患者的癫痫灶。Objective To study the characteristics, influence factor and clinical value of magnetoencephalography （MEG） in patients of epilepsy associated with Sturge-Weber syndrome. Methods A retrospective study was conducted at Magnetoencephalography Laboratory of Sanbo Brain Hospital, Capital Medical University. Fourteen patients of epilepsy associated with Sturge-Weber syndrome were enrolled into the study between October 2010 and June 2016. The following data were analyzed including the results of MEG with Long-term video-EEG （ scalp ） monitoring and preoperative MRI in all patients. Results In 8 out of 14 cases, the background activities of MEG were weakened. Epileptiform discharges were detected in 11 cases including 9 cases with epileptogenic zone on ipsilateral side of intracranial lesion （angioma, 6 cases on the right side and 3 eases on the left side） and 2 cases with bilateral epileptogenic zones. Both interictal EEG and MEG detected epileptiform discharges in 9 out of 14 cases. Epileptiform discharges were observed in 2 eases by MEC only and in 1 case by EEG only. Neither MEC or EEG detected any epileptiform discharges in 2 cases. ConcLusions The interictal results of MEG seem similar to those of EEG in eases of Sturge-Weber syndrome, which mainly include weakening of background activities and epileptiform discharges commonly on ipsilateral side of brain lesion and rarely on both sides or contralateral hemisphere. The magnetic source imaging technology combining MEG and MRI could help localize the epileptogenic zone in Sturge-Weber syndrome.

关 键 词：Sturge—Weber综合征 癫痫 脑磁图描记术 磁源成像 

分 类 号：R596[医药卫生—内科学] R742.1[医药卫生—临床医学]