脑电偶极子分析在痫灶切除术中的定位价值

目的探讨长程视频脑电监测和偶极子分析在痫灶切除术中的定位价值。方法对35例开颅痫灶切除术患者术前行常规脑电和长程视频脑电监测,脑电痫性放电进行偶极子分析,并与手术中硬膜下电极记录的脑电相对照。结果35例患者视频脑电图监测异常35例,有痫性放电者35例;常规脑电图异常28例,有痫性放电者18例;行常规脑电图监测无典型癫痫发作出现。两者之间脑电异常率、痫性放电阳性率、典型临床发作率都有统计学意义。以术中硬膜下电极记录为标准,头皮脑电偶极子定位异常放电灶的准确率为97%,切除病灶病理检查异常率86%。偶极子定位误差一般<15mm。结论长程视频脑电监测和头皮脑电偶极子定位癫痫起源灶可为开颅痫灶切除手术提供有价值的信息。

Application of EEG Dipole analysis in epilepsy surgery

Objective To evaluate the use of long-term video electroencephalography (VEEG) and EEG dipole analysis in locating of epileptognic focus in patients with refractory epilepsy. Methods Before operalion, routine EEG and long-term VEEG recording were performed on 35 patients with partial epilepsy. Epileptogenic foci were located by the spike-sharp-wave EEG dipole analysis in the 35 patients with refractory epilepsy, and ECoG was used in surgical procedures. Results All the 35 patients had abnormalities in long-term VEEG, and all of them had interictal epileptiform EEG abnormalities and epileptic seizures. However, there were 28 (80%) of 35 patients had routine EEG abnormalities, 18 (51%)of 35 patients had interictal epileptiform EEG abnormalities and none of them had epileptic seizure. In 34 out of 35 patients (97%) , the localization of epileptogenic foci by EEG dipole analysis was consistent with that by EcoG. And there were 30 out of 35 patients (86%)who had pathologic changes in the resected tissues. Compared with ECoG, the error of EEG dipole analysis was less than 15mm. Conclusions Long-term video electroencephalography and EEG dipole analysis ean give valuable informations to the operation of resecting ietical onset zone.