脑磁图对难治性癫痫致痫区定位价值

目的探讨脑磁图癫痫定位技术对难治性癫痫致痫区定位的价值。方法回顾性分析难治性癫痫病人58例，术前行视频头皮脑电图、磁共振、脑磁图、颅内埋藏电极皮层脑电图等检查，综合评估确定致痫灶的位置。根据综合评估致痫区制定手术方案并实施，随访并判定疗效。根据脑磁图癫痫定位和综合评估致痫区吻合度分为3组，Ⅰa组：完全吻合一两区域中心位置在1cm以内，Ⅰb组：基本吻合一两区域中心位置在1～3cm;Ⅱ组：不吻合一两区域中心位置在3cm以外或其他。统计分析各组间疗效的差异。结果本组总有效率为77．6％（45／58），其中癫痫完全消失18例；Ⅰa、Ⅰb组手术疗效无明显差异，但Ⅰ组手术疗效明显优于Ⅱ组。结论脑磁图癫痫定位是难治性癫痫术前评估的重要方法之一，当脑磁图癫痫定位和术前综合评估致痫区基本一致时，手术疗效相对较好。

Localization value of magnetoencephalography to epileptogenic zone in refractory epilepsy

Objective To evaluate the value of the magnetoencephalography to the localization of the epileptogenic zone in refractory epilepsy. Methods 58 patients with refractory epilepsy underwent video scalp EEG,MR, MEG and invasive EEG examination. The epileptogenic zones were precisely localized in pre-operation evalution. The microsurgery were performed and the therapeutic effect were estimated during the follow-up. According to the relationship of the presurgical evaluated epileptogenic zones and MEG, they were divided into 3 groups, Ⅰ a（ 〈 1cm） , Ⅰ b（1 -3cm）, Ⅱ（ 〉3cm or others） The curative effects were analyzed among each groups. Results Good postsurgical seizure outcome was attained in 45 （77.6%） patients including 18（31.0% ）who were seizure free. The therapeutic effects of group Ⅰa and Ⅰ b had no significant differences （P 〉0.05）, while group Ⅰ was much better than group Ⅱ（P 〈0. 05）. Conclusions Aggregate analysis is needed to localizing the epileptogenic zones in the refractory epilepsy surgery. MEG might be of important value in the localization. Good postsurgical seizure outcome could be attained when the presurgical evaluated epileptogenic zone was consistent with MEG.