表面蝶骨电极联合脑电图监测对颞叶内侧癫痫诊断的效果  

Application of surface sphenoidal electrodes with video EEG in the diagnosis of temporal lobe epilepsy

作　　者：张弘弛[1] Zhang Hongchi(Department of Neurology,Guizhou Provincal Hospital,Guiyang,Guizhou 550001,China)

机构地区：[1]贵州省人民医院神经电生理科,贵州贵阳550001

出　　处：《实用医技杂志》2023年第8期565-568,共4页Journal of Practical Medical Techniques

摘　　要：目的观察表面蝶骨电极联合脑电图检查在颞叶内侧癫痫诊断的应用价值。方法回顾分析2021年1月至12月就诊于贵州省人民医院神经电生理科初诊疑似颞叶内侧癫痫患者100例,分别进行常规脑电图(REEG)、视频脑电图(VEEG)及VEEG+表面蝶骨电极监测,对比3种检查的痫样放电检出率、局灶性发作和全面性发作的痫样放电检出率,其定位结果与磁共振成像(MRI)结果进行比较。结果VEEG联合表面蝶骨电极检查痫样放电检出率93%(93/100)高于REEG 23%(23/100)、VEEG 86%(86/100),差异有统计学意义(P<0.05)。在全面性癫痫患者诊断中,VEEG联合表面蝶骨电极检查痫性放电检出率88%(37/42)高于REEG、VEEG检查痫性放电检出率21%(9/42)、83%(35/42),差异有统计学意义(P<0.05)。在局灶性癫痫患者诊断中,VEEG联合表面蝶骨电极检查痫性放电检出率94%(33/35)高于REEG、VEEG检查痫性放电检出率29%(10/35)、83%(35/42),差异有统计学意义(P<0.05)。疑似颞叶内侧癫痫的患者,无论何种发作形式,颞区痫样放电占77%(77/100)明显高于其他脑区14%(14/100)。VEEG+蝶骨电极对于病灶侧别的单侧测定率59%(59/100)高于REEG、VEEG及MRI检测的11%、54%、30%(11/100、54/100、30/100),差异具有统计学意义(P<0.05)。结论蝶骨电极+VEEG联合监测对颞叶内侧癫痫患者的痫样放电检出率有积极作用。Objective To investigate the application value of surface sphenoidal electrodes combined with video eeg in the diagnosis of medial temporal lobe epilepsy.Methods One hundred patients with suspected medial temporal lobe epilepsy who attended our department for initial diagnosis from January 2021 to December 2021 were retrospectively analyzed,and performed REEG,VEEG and VEEG+surface pterionic electrodes,respectively.The detection rate of epileptic discharge was compared between the three tests,the detection rate of epileptic discharge in focal seizure and general seizure,and the localization results were compared with the MRI results.Results 93%(93/100)of VEEG combined with sphenoid electrode was higher than 23%(23/100)of REEG and 86%(86/100)of VEEG,and there was statistically significant(P<0.05).In the diagnosis of general epilepsy,the detection rate of epileptogenic discharge by VEEG combined with sphenoid electrode was 88%(37/42),which was higher than that by REEG and VEEG[21%(9/42),83%(35/42)],and there was statistically significant(P<0.05).In the diagnosis of focal epilepsy,94%(33/35)of VEEG combined with sphenoid electrode was more sensitive than 29%(10/35)and 83%(35/42)of REEG and VEEG,and there was statistically significant(P<0.05).In patients with suspected mesial temporal lobe epilepsy,77%(77/100)of epileptiform discharges in temporal region were significantly higher than that in other brain regions(14/100).The one-sided detection rate of VEEG+sphenoid electrode was 59%(59/100),higher than that of REEG,VEEG and MRI(11%,54%,30%,11/100,54/100,30/100),and there was statistically significant(P<0.05).Conclusion The surface sphenoidal electrode combined with VEEG has a positive effect on the detection rate of diagnosis of medial temporal lobe epilepsy,and plays an important role in the treatment of medial temporal lobe epilepsy.

关 键 词：蝶骨 脑电描记术 癫痫 颞叶 

分 类 号：R742.1[医药卫生—神经病学与精神病学]