长程蝶骨电极脑电图对颞叶痫灶的定位价值探讨

目的 探讨长程蝶骨电极脑电图对颞叶痫灶的定位价值.方法 回顾性分析经手术治疗的119例颞叶癫痫患者,将其术前的常规脑电图 蝶骨电极(以下简称常规蝶骨电极)与视频脑电图 长程蝶骨电极脑电图(以下简称长程蝶骨电极)检测结果进行分析,其定位结果与术中描记的皮层脑电图(ECoG)及深部脑电图(DEEG)结果进行比较.结果 痫样放电在常规蝶骨电极和长程蝶骨电极的总检出率分别为68.9%和94.1%;其定侧率各为67.1%和99.1%(P＜0.005).术中脑电图证实了术前的长程蝶骨电极脑电图定位准确率高,DEEG与长程蝶骨电极定位吻合率达98.2%.本组随访1～5年,总有效率为97.4%,效果优良为88.6%.结论 长程蝶骨电极对颞叶痫样放电的检出和定侧率高,且准确率高.准确定位可提高手术疗效.

The localization of epileptogenic foci with continual sphenoidal electrodes in temporal epilepsy

Objective To explore the role of continual sphenoidal electrodes in temporal epileptic foci localizing. Methods The EEGs of conventional sphenoidal electrodes and continual sphenoidal electrodes were compareded in 119 surgical patients with temporal epilepsy, and these results also compared with data of ECoG and Depth EEG. Results 68. 9% of patients demonstrated epilepitiform discharges in conventional sphenoidal electrodes EEGs,and 94. 1% in continual sphenoidal electrodes. The ratio of lateral epileptic foci localizing were 67. 1% in conventional sphenoidal electrodes EEGs,and 99. 1% in continual sphenoidal electrodes respectively. The consistency of epileptic foci localization was 98. 2% between continual sphenoidal electrodes and DEEG. At 1-5 years follow-up,gross efficiency rate was 97. 4%, and conspicuous efficiency rate was 88. 6% in this group. Conclusion The continual sphenoidal electrodes results in higher ratio of epileptic discharge detection and lateral epileptic foci localization, and this exact epileptic loci localization may bring favorable outcome after surgical interruption.