86例癫痫痫灶定位与脑电图懒波

目的探讨86例脑电图一侧懒波、另一侧痫样放电癫痫患者的病史特点及痫灶定位。方法回顾性总结分析86例一侧懒波、另一侧痫样放电癫痫患者的病史、脑电图特点,并结合影像学改变、临床发作及发作期偶极子定位系统密度压缩谱阵(DSA)分析进行讨论。结果蛛网膜囊肿、外伤后脑软化灶和脑萎缩所致懒波常见,分别为24.4%(21/86)、23.3%(20/86)和18.6%(16/86)。42例行术中皮质及深部脑电图探测,证实了术前定位。结论脑电图一侧懒波,另一侧痫样放电时,其懒波侧多为原发痫灶侧。存在此类脑电图特有表现的癫痫患者中,以继发性癫痫多见(94.2%,81/86),但少数病程较长的顽固性原发性癫痫也可出现类似表现(5.8%)。准确找出原发致痫灶并予以切除,可获得良好的治疗效果。

Analysis of Relationship between Localization of Epileptogenic Foci and Lazy Waves of EEG in 86 Patients

Objective To explore the localization of epileptogenic foci and the characteristics in 86 patients with lazy waves in one side of hemisphere and epileptiform waves in the other side hemisphere. Methods The characteristics of medical history and electroencephalogram (EEG) in 86 patients with lazy waves in one side of hemisphere and epileptiform waves in the other side of hemisphere combined with changes in imaging, clinical seizure, and density spectrum array (DSA) of ictal EEG were analyzed retrospectively. Results Of 86 patients with epilepsy, 81 were diagnosed as secondary epilepsy and 5 as primary epilepsy. The lazy waves induced by arachnoid cysts, traumatic encephalodialysis and encephalatrophy were common and accounted for 24.4%(21/86), 23.3%(20/86), 18.6% (16/86) respectively in all the patients. The eplieptogenic foci localized before the operation were intraoperatively identified by electrocorticogram and depth EEG in 42 patients. Conclusions The epileptogenic foci are in the side of the hemisphere with lazy waves when EEG shows lazy wave in one side of hemisphere and epileptiform waves in the other side of the hemisphere in the patients with epilepsy for 94.2% of which the secondary epilespsy accounts and for 5.8% the primary intractable epilepsy. The best effect can be obtained by finding and resecting the epileptogenic foci accurately.