非侵袭性检查定位致痫灶在癫痫外科治疗中的作用

目的 评价非侵袭性检查方法定位致痫灶在癫痫外科治疗中的作用。方法 对30例难治性癫痫病人行EEG、MRI、PET检查，根据3项检查结果选择外科治疗方法（开颅手术，X－刀治疗，立体定向手术）。开颅手术，术中行皮层脑电图（ECoG)检查。结果 致痫灶位于颞叶22例，颞叶外6例，额颞区2例。方法 开颅手术16例，X－刀治疗10例，立体定向手术4例。术后除2例发作无明显改善外，28例病人发作均明显减少或消失。结论 大部分难治性癫痫病人，尤其是颞叶癫痫，开颅致痫灶切除、放射外科、立体定向手术可以根据EEG、MRI、PET检查来定位，避免术前侵袭性EEG（如植入深部电极等）检查的危险性。

Evaluation of noninvasive protocol in the localization of epileptic foci for surgical treatment

Objective To evaluate the value of the noninvasive methods localizing epileptic foci for surgical treatment.Method30patients with intractable epilepsy received the examination of EEG,MRI,18 F-FDG PET,and underwent surgical treatment (treated after craniotomy,X-knife,stereotactic operation)according to the results of examination.Resutl22of the patients had temporal,6had extratemporal and2had frontal-temporal epilepsies.All patients were treated according to the noninvasive localization method,16patients were treated by craniotomy,10by X-knife and4by stereotactic operation.Only2patients remained seizure as before,the others were completely or mostly had seizure free.Conclusion In a considerable number of patients with intractable temporal focal epilepsy,resective surgery,X-knife and stereotactic operation can be based on noninvasive methods.The risk of invasive EEG monitoring can be avoided.