视频脑电图监测在癫痫外科中的临床意义

目的 探讨视频脑电图（V-EEG）监测在癫痫外科中的作用.方法 52例均行常规脑电图（REEG）和V-EEG检查,其中有15例在经过详细的术前评估后行了手术治疗,术中均行了皮层脑电图（ECoG）监测,并将V-EEG与REEG和ECoG的监测结果进行比较.结果 52例V-EEG监测显示轻度异常脑电图1例,中度异常脑电图44例,重度异常脑电图7例.除1例外,其它在监测中均发现有痫样放电,痫样放电的阳性率为98.1%（51/52）,18例（34.6%）在监测中至少观察到1次临床发作.V-EEG监测痫样放电的阳性率与REEG（40.4%）之间经统计学比较有极显著性差异（P〈0.01）.同时,V-EEG与ECoG的定侧符合率为100%,定位符合率为80%.结论 V-EEG监测在顽固性癫痫患者术前定位致痫灶方面具有一定的指导意义,它明显优于REEG,且与术中ECoG有很高的符合率.

Clinical Significance of Video-EEG Monitoring in Epilepsy Surgery

Objective To explore the clinical significance and effect of video-EEG(V-EEG) monitoring in epilepsy surgery.Methods In this group there were 30 males and 22 females,All the patients underwent routine EEG(REEG) and V-EEG,and after careful pre-operative evaluation,15 cases underwent operations.During the operation,electrocorticogram(ECoG) monitoring was performed.The results of V-EEG monitoring were compared with REEG and ECoG.Results The result of V-EEG monitoring showed slightly abnormal EEG in 1 case,moderately abnormal EEG in 45 and severely abnormal EEG in 7.Except for 1 case,epileptic discharges were recorded in all cases,and the positive rate of epileptic discharge was(98.1%)(51/52).At least one attack was observed in 18 cases((40.4%)).There was significant difference in the positive rate of epileptic discharge between V-EEG and REEG(P<(0.01)).Meanwhile,the concordant rate of V-EEG and ECoG in lateralization was 100% and localization 80%.Conclusion V-EEG monitoring has some significance in preoperative localization of epileptic lesion of refractory epilepsy cases.