头皮EEG偶极子定位在癫癎外科中的应用研究

目的：研究头皮EEG偶极子定位方法在癫痫手术病人中的应用价值及其准确性。方法：在80例难治性癫痫手术病人中．术前在发作间期头皮EEG上用偶极子定位方法定出致痫源放电位置．术中以皮质电图(ECoG)及脑深部电极记录确定致痫区．对比偶极子定位的准确性．按ECoG定出的位置直接对致痫区进行手术处理．术后随访手术效果。结果：在颞叶癫痫．偶极子定位与ECoG及脑深部电极定位完全一致；在额、顶、枕叶癫痫，偶极子位置误差为10～15mm。随访6～24个月(平均13个月)，80例中71％的病人无癫痫发作，25％的病人发作减少75％以上．手术有效率96%。结论：头皮EEG的偶极子定位方法无创、准确，相当于脑磁图，可避免创伤性检查而用于癫痫病人的术前定位。

Study of dipole source imaging for pre-operative localization of the epileptogenic discharges in patients with intractable epilepsy

Objective:To explore the feasiability of dipole source imaging for pre-surgical localization of the epileptogenic zone in patients with intractable epilepsy. Methods:To compare the accuracy of the localization of epileptogenic zone by pre-surgical scalp EEG dipole source imaging and ECoG during operation in 80 patients with intractable epilepsy. Results:For localization of the epileptogenic zone, dipole source imaging has no error in temporal lobe epilepsy and has an error with a tolerance of less than 15 mm in extra-temporal lobe epilepsy. Conclusions:The error of localization for epileptogenic zone by dipole source imaging from a scalp EEG is quite small and it can be used and instead of the invasive recordings in pre-surgical localization of the epileptgenic zone for epilepsy surgery.