脑磁图定位颞叶癫痫病灶及手术疗效的前瞻性研究  

Magnetoencephalography source localiza-tion and surgical outcome in temporal lobe epilepsy

作　　者：Assaf B.A. Karkar K.M. Laxer K.D. 张勇 

机构地区：[1]Department of Neurology, The University of Illinois-Peoria, 530 N. Glen Oak Ave., 61637, Peoria, IL, United States

出　　处：《世界核心医学期刊文摘（神经病学分册）》2005年第1期6-7,共2页Digest of the World Core Medical Journals:Clinical Neurology

摘　　要：Objective: We prospectively investigated the role of magnetoencephalography (MEG) in localizing the seizure focus and in predicting outcome to surgical resections for intractable temporal lobe epilepsy (TLE). Methods: We performed simultaneous interictal EEG and MEG recording (two 37- channel system) in 26 TLE patients followed by MEG source localization. We correlated early modeling dipoles with intracranial EEG, temporal surgical resection and surgical outcome. Results: There were 12 patients who had anterior temporal horizontal or tangential dipoles to the anterior infero lateral temporal tip cortex. Two patients underwent selective amygdalo hippocampectomy (SAH) and nine patients had antero medial temporal lobectomy (AMTL). All patients had successful outcome except for one patient who initially failed SAH, but became seizure free after AMTL. There were 11 patients who demonstrated anterior temporal vertical or tangential oblique dipoles. Five patients had AMTL and three had SAH; all became seizure free. Five of above 23 patients had invasive EEG and demonstrated mesial seizure onset. Three TLE patients had lateral vertical dipoles that were concordant with intracranial EEG and these became seizure free after temporal neocortical resections. Conclusions: MEG source analysis produces distinct source patterns that provide useful localizing information, predict surgical outcome, and may aid in planning limited surgical resection in TLE.Objective: We prospectively investigated the role of magnetoencephalography (MEG) in localizing the seizure focus and in predicting outcome to surgical resections for intractable temporal lobe epilepsy (TLE). Methods: We performed simultaneous interictal EEG and MEG recording (two 37- channel system) in 26 TLE patients followed by MEG source localization. We correlated early modeling dipoles with intracranial EEG, temporal surgical resection and surgical outcome. Results: There were 12 patients who had anterior temporal horizontal or tangential dipoles to the anterior infero lateral temporal tip cortex. Two patients underwent selective amygdalo hippocampectomy (SAH) and nine patients had antero medial temporal lobectomy (AMTL). All patients had successful outcome except for one patient who initially failed SAH, but became seizure free after AMTL. There were 11 patients who demonstrated anterior temporal vertical or tangential oblique dipoles. Five patients had AMTL and three had SAH; all became seizure free. Five of above 23 patients had invasive EEG and demonstrated mesial seizure onset. Three TLE patients had lateral vertical dipoles that were concordant with intracranial EEG and these became seizure free after temporal neocortical resections. Conclusions: MEG source analysis produces distinct source patterns that provide useful localizing information, predict surgical outcome, and may aid in planning limited surgical resection in TLE.

关 键 词：颞叶癫痫 脑磁图 病灶切除 颞叶切除术 癫痫病灶 发作间期 术后癫痫 前颞叶 新皮层 切线位 

分 类 号：R742.1[医药卫生—神经病学与精神病学]