术中皮质体感诱发电位与电刺激术定位脑功能区

目的探讨脑功能区手术中利用脑皮质体感诱发电位(SEP)及直接皮质电刺激定位脑功能区的方法及意义。方法对10例脑功能区病变病人在唤醒麻醉下进行手术，利用皮质SEP及皮质直接电刺激定位感觉区、运动区及语占区，住保护脑功能区的前提下，手术切除病变。结果7例病人利用SEP及皮质电刺激确定出运动感觉区，其中4例利用SEP位相倒置确定出中央沟，3例病变位于左侧额颞叶的病人通过皮质直接电刺激确定出语言区?术后功能均较术前明显好转。结论术中SEP及直接皮质电刺激可准确、实时确定脑功能区，最大程度地保护功能，切除病变。

Cortical mapping on eloquent areas by somatosensory evoked potential and direct cortical electrical stimulation

Objective To study the methods and significance of cortical mapping by somatosensory evoked potential and direct cortical electrical stimulation during the operation of patients with lesions on eloquent areas. Methods 10 patients with brain lesions on the eloquent areas were undergone surgery with awaking anaesthesia. The somatosensory evoked potential and direct cortical electrical stimulation were performed to detect the motor, sensory and language areas before the lesions removal. The brain lesions were removed in the case of eloquent areas preservation. Results The motor-sensory cortex was confirmed by somatosensory evoked potential and direct cortical electrical stimulationin 7 patients with lesions on the motor-sensory areas. The somatosensory evoked potential phase reversal was detected in 4 patients. The language cortex was ensured by direct cortical electrical stimulation in 3 patients with frontal-temporal lesions. There is no permanent deterioration of dysfunction after the operation. The preoperative dysfunction was improved in all patients. There was no notable complication during and after the operations. Conclusion Intra-operative somatosensory evoked potential and direct cortical electrical stimulation is a reliable, precise and safe method to detect eloquent areas, which allows a maximum resection of lesions and protection of the normal function.