间歇期头皮脑电图在儿童结构性癫痫外科治疗决策中的指导价值  

Guiding value of intermittent scalp electroencephalogram in decision-making of surgical treatment of children with structural epilepsy

作　　者：谢艳平 苏绮璇 李萍 许新科 Xie Yanping;Su Qixuan;Li Ping;Xu Xinke(Department of Neurosurgery,Guangzhou Women and Children's Medical Center,Guangzhou Medical University,Guangzhou City,Guangdong Province,510120,China)

机构地区：[1]广州医科大学附属妇女儿童医疗中心神经外科,广东省广州市510120

出　　处：《现代电生理学杂志》2025年第1期1-5,共5页Journal of Modern Electrophysiology

摘　　要：目的探讨间歇期头皮脑电图在儿童结构性癫痫外科治疗决策中的指导价值。方法回顾性纳入2018年1月至2023年8月广州市妇女儿童医疗中心神经外科结构性癫痫行切除术的患儿,共84例。分析其术前头皮脑电图,应用Engel分级标准评估术后疗效,了解间歇期及发作期头皮脑电图在术前评估中对手术疗效的影响。结果84例患儿,术前单纯依据间歇期脑电图异常定位手术的75例(89.29%),需要同时依据惯常发作期脑电图定位手术的9例(10.71%)。术后随访时间为6个月至5年,按Engel预后分级判断疗效,仅依据间歇期脑电图定位的75例患儿,术后癫痫控制达EngelⅠ级71例(94.67%);需要同时依据惯常发作期定位的9例患儿,术后癫痫控制达EngelⅠ级8例(88.89%)。两者比较差异无统计学意义(X^(2)=0.165,P=0.441)。结论儿童结构性癫痫外科治疗术前评估不同于成人,头皮脑电图简单易行,间歇期头皮脑电图在儿童结构性癫痫外科治疗决策中具有较大指导价值。Objective To investigate the guiding value of intermittent scalp electroencephalogram(EEG)in surgical treatment of structural epilepsy in children.Methods A total of 84 children who underwent resection of structural epilepsy in the Department of Neurosurgery of Guangzhou Women and Children's Medical Center from January 2018 to August 2023 were retrospectively analyzed.The preoperative scalp EEG was analyzed,and the Engel grading criteria was applied to evaluate the postoperative efficacy,and the influence of intermittent and seizure scalp EEG on the operative efficacy was understood.Results Of the 84 children,75 cases(89.29%)were operated on the basis of EEG abnormality in intermittent period before operation,and 9 cases(10.71%)needed to be operated on the basis of EEG abnormality in attack period at the same time.The postoperative follow-up time ranged from 6 months to 5 years.The therapeutic effect was evaluated according to Engel prognostic classification.75 children were located only by intermittent EEG,and 71 cases(94.67%)achieved Engel I level of postoperative epilepsy control.Among the 9 children who needed to be located based on their usual seizure period,8 cases(88.89%)achieved Engel I grade after surgery.There was no significant difference(X^(2)=0.165,P=0.441).Conclusion Preoperative evaluation of structural epilepsy in children is different from that in adults.Scalp EEG is simple and feasible.Intermittent scalp EEG is of great guiding value in surgical treatment decision-making of structural epilepsy in children.

关 键 词：脑电描记术 儿童 结构性癫痫 

分 类 号：R74[医药卫生—神经病学与精神病学]