颞叶癫痫致痫灶的定位方法评价

探讨目的：用不同的方法对癫痫灶定位的评估。病程１２１．２个月，进行回顾。方法：利用症状学，神经心理学，头皮／蝶骨嵴脑电皮层脑电图，深部脑电图，ＣＴ，ＭＲＩ七种方法在４０例难治性颞叶癫痫中的应用，其中１３例患者定位的准确性通过手术后一年以上疗效的随访得到证实。结果：２１／４０例由症状学表现得到诊断，９／２７例由神经心理学测试定侧。头皮脑电图、皮层脑电图及深部脑电图的定位率分别为３０／４０、３０／３７和２９／３５。ＣＴ与ＭＲＩ的定位率分别为１２／２５和３２／４０。各种定位方法的准确性有显著差异，其中神经心理学的定位能力明显低于常规脑电图、ＭＲＩ、皮层脑电图和深部脑电图。结论：总结了各种定位方法的优劣势，指出准确的定位需要功能性定位与结构性定位方法的综合应用。最具价值的仍是侵袭性电极的检查，神经心理学的定位价值较小

Evaluation of different approach for localization epileptogenic foci in patient with temporal lobe seizure

Objective:To assess the ability of different methods for localized the epileptogenic foci.Method:Retrospectively studied forty patients with intractable temporal lobe epilepsy.Result:Epileptogenic foci ean be correctly localized in 21 of cases by semiological study,in 9 of 27 cases by neuropsychological assessment,30 of 40 cases by routine surface/sphenoid electroencephalography(EEG),30 of 37 cases by electrocorticography(EcoG),29 of 35 cases by depth EEG(DEEG),12 of 25 cases by CT scan 32 of 40 cases by MRI.The localization value of neuropsychological assessment in disclosing the epileptogenic foci was obviously lower than electrophysiological and neuroimaging(MRI) examination.Conclusion:All the methods can Provide some useful information and comprehensive procedure was necessary in localizing the epileptogenic foci.It is emphasized that the conoordance of structure lesion and focal functional abnormality can provide the most exact localization of epileptogenic foci.