脑磁图累积源成像在药物难治性颞叶癫痫术前评估中的应用  

Application of magnetoencephalographic accumulated source imaging in preoperative assessment of patients with refractory temporal lobe epilepsy

作　　者：罗磊 朱海涛[1] 徐宏浩 张锐[1] LUO Lei;ZHU Hai-tao;XU Hong-hao;ZHANG Rui(Department of Functional Neurosurgery,Brain Hospital Affiliated of Nanjing Medical University,Nanjing 210000,China)

机构地区：[1]南京医科大学附属脑科医院功能神经外科,南京210009

出　　处：《中国临床神经外科杂志》2021年第2期72-76,共5页Chinese Journal of Clinical Neurosurgery

基　　金：南京市医学科学技术发展项目(YKK17136)。

摘　　要：目的探讨脑磁图累积源成像(MEG)在难治性颞叶癫痫术前评估中的应用价值。方法回归分析法2006年1月至2018年1月手术治疗的11例难治性颞叶癫痫临床资料。使用MRI、长程视频脑电图、MEG以及颅内电极脑电图(IEEG)帮助定位致痫灶并制定手术方案,术后随访1年,按Engel分级评估疗效。结果MRI无明显异常5例;异常6例,其中2例与手术侧一致。11例IEEG均有异常,其中9例与手术侧一致。11例MEG均有异常,9例与手术侧一致,主要集中在4~30 Hz;MEG与IEEG一致7例。11例中,9例有效,2例无效;其中Engel分级Ⅰ级6例,Ⅱ级1例,Ⅲ级2例,Ⅳ级2例。结论MEG分析能为难治性颞叶癫痫术前评估提供重要信息,帮助识别致痫灶和潜在癫痫网络。Objective To explore the application value of the magnetoencephalographic accumulated source imaging(MEG)in the preoperative assessment of the patients with refractory temporal lobe epilepsy.Methods The clinical data of 11 patients with refractory temporal lobe epilepsy who underwent surgery from January 2006 to January 2018 were analyzed retrospectively.MRI,videoelectroencephalography,MEG and intracranial electrography(IEEG)were used to locate the epileptogenic foci and help make the operative plan.All the patients were followed up for 1 year and the curative efect was assessed using Engel grade.Results For the location of epileptogenic foci,MRI showed no abnormalities in 5 patients and abnormalities in 6 of whom 2 were consistent with the surgical results;IEEG showed abnormalities in all the 11 patients of whom 9 were consistent with the operation results;MEG showed abnormalities in all the 11 patients of whom 9 were consistent with the operation results.The MEG results were consistent with IEEG in 7 patients.One year after the operation,Engel gradeⅠwas achieved in 6 patients,gradeⅡin 1,gradeⅢin 2,and gradeⅣin 2.Conclusions MEG can provide important preoperative information for refractory temporal lobe epilepsy and help identify epileptogenic foci and possible epileptogenic networks.

关 键 词：难治性颞叶癫痫 术前评估 脑磁图累积源成像 

分 类 号：R651.1[医药卫生—外科学]