地氟醚对癫痫和非癫痫病人脑电图的影响

目的对比观察不同呼气末地氟醚浓度时癫痫及非癫痫病人脑电图及棘波的变化。方法20例癫痫需行手术治疗及15例非癫痫开颅手术病人,以浓度1.0 MAC的地氟醚维持麻醉,术中置入硬膜外电极后,调整蒸发器刻度,分别控制呼气末地氟醚浓度于0.7、1.0、1.3及1.5 MAC,并各稳定15 min后描记脑电图。结果癫痫病人1.0 MAC地氟醚时棘波的频率与0.7 MAC时相比无明显变化,而1.3和1.5 MAC时棘波的频率明显少于0.7 MAC时(P<0.01)。非癫痫病人在0.7、1.0、1.3及1.5 MAC地氟醚时均无棘波出现。随着呼气末地氟醚浓度的升高,所有病人的α和β波逐渐减少,而δ波增多。结论癫痫手术用地氟醚维持麻醉,术中需行皮层脑电图监测时,将地氟醚麻醉深度维持于0.7~1.0 MAC较为适宜,以保证癫痫源灶准确的定位及手术切除范围。     

颅内电极长程记录在颞叶癫痫定位中的应用

目的 探讨颅内电极长程记录在颞叶癫痫定位、定侧中的应用,评价其临床价值.方法 2006年1月至2010年10月北京天坛医院神经外科60例经颅内电极定位的颞叶癫痫患者,电极类型采用硬膜下条状、栅状以及深部电极,手术方式包括颅骨钻孔电极植入、立体定向深部电极植入和骨瓣开颅电极植入.结果 额-颞皮层电极植入34例,额-颞前-颞枕交界电极植入7例,双颞皮层电极植入7例,深部电极联合颞叶皮层电极植入7例,颞前-颞枕交界电极植入3例,条状电极联合栅状电极植入2例.手术方式包括前颞叶切除术50例,联合额叶致痫灶切除7例,联合胼胝体切开1例,颞后枕新皮层痫灶切除联合海马杏仁核切除2例.结论 颅内电极长程记录是一种有效的检查方法和重要的定位手段,可应用于无创评估方法难以定位、定侧的颞叶癫痫.     

七氟烷用于癫痫手术麻醉及其对脑电图的影响

Objective To assess the effects of concentration of sevoflurane on the electrocorticogram (ECoG) of intractable epileptic patients or non-epileptic patients undergoing surgery and investigate the suitable concentration of sevoflurane for epilepsy surgery. Methods Of 24 patients with intractable epilepsy and 15 patients with non-epilepsy but brain diseases, ECoG were recorded under sevoflurane anesthesia with 0.7 minimum alveolar anesthetic concentration (MAC), 1.0 MAC, 1.3 MAC, and 1.5 MAC, respectively, under similar ventilatory conditions. Spike activity and other frequency brain waves were evaluated. Results The frequencies and leads of spike waves (or spike-form waves) were similar with 0.7-1.3 MAC sevoflurane anesthesia in epileptic patients, whereas the spike waves were significantly increased at 1.5 MAC in epileptic patients and 5 of 15 non-epileptic patients (P<0.05). The change of other frequencies brain waves was similar in both group: the frequency of α and β waves decreased, δ waves increased and θ waves changed a little. Conclusion The maintenance of anesthesia with 0.7-1.3 MAC sevoflurane is safe and suitable for the craniotomy surgery of epileptic patients with ECoG monitoring. Careful attention should be paid to the higher concentration of sevoflurane (>1.5 MAC) used when intraperative ECoG is used in both epileptic patients and non-epilepsy patients.     

脑梗塞患者各项电生理指标的比较研究

本文对80例幕上脑梗塞患者在 CT 扫描后同一时间进行脑电图,脑电地形图,体感诱发电,脑干听觉诱发电位等多项电生理指标的测定,并比较各项指标在不同时间,不同部位的灵敏程度。结果总的异常率 CT95%,CME95%,EEG94%;BAEP65%,SEP55%。急性期 CME 异常率较 CT 略高,慢性期则低于 CT。病变位于皮层表浅部位者脑电地形图的异常率高,诱发电位皮层下比皮层的阳性率高。     

跳水引起脊髓损伤一例临床及肌电图报告

2000年8月一名14岁男孩在河中游泳跳水时,胸部平铺入进水中,4—5分钟后感背部刺痛,约30分钟后在当地医院就诊,经补钾钙治疗,疼痛好转(查血钾4.0mmol/L,钙1.9mmol/L),但出现四肢无力,行走困难,双手十指无法伸直,上楼乏力。查体:神清,语利,颈软,颅神经检     

七氟烷用于癫痫手术麻醉及其对脑电图的影响

Objective To assess the effects of concentration of sevoflurane on the electrocorticogram (ECoG) of intractable epileptic patients or non-epileptic patients undergoing surgery and investigate the suitable concentration of sevoflurane for epilepsy surgery. Methods Of 24 patients with intractable epilepsy and 15 patients with non-epilepsy but brain diseases, ECoG were recorded under sevoflurane anesthesia with 0.7 minimum alveolar anesthetic concentration (MAC), 1.0 MAC, 1.3 MAC, and 1.5 MAC, respectively, under similar ventilatory conditions. Spike activity and other frequency brain waves were evaluated. Results The frequencies and leads of spike waves (or spike-form waves) were similar with 0.7-1.3 MAC sevoflurane anesthesia in epileptic patients, whereas the spike waves were significantly increased at 1.5 MAC in epileptic patients and 5 of 15 non-epileptic patients (P<0.05). The change of other frequencies brain waves was similar in both group: the frequency of α and β waves decreased, δ waves increased and θ waves changed a little. Conclusion The maintenance of anesthesia with 0.7-1.3 MAC sevoflurane is safe and suitable for the craniotomy surgery of epileptic patients with ECoG monitoring. Careful attention should be paid to the higher concentration of sevoflurane (>1.5 MAC) used when intraperative ECoG is used in both epileptic patients and non-epilepsy patients.     

PET和EEG在顽固性癫痫诊断中的价值

目的探讨电视录像-动态脑电图监测(VEEG)和正电子发射断层扫描(PET)在癫痫灶定位诊断中的价值及两者之间的联系.方法 44例顽固性癫痫患者, 经VEEG及PET检查定位, 对两者的一致性进行了比较.在其中38例进行了癫痫外科手术治疗的患者中进一步记录了术中ECoG和术后病理,与上述两者进行比较.结果 PET阳性率为98%,EEG为95%;两者完全一致和部分一致率分别为50%和23%.在PET和EEG定位完全不一致的12例手术患者中,8例术中ECoG与PET相符,2例与EEG相符.结论 PET是诊断癫痫病灶灵敏有效的一种无创性检查,在EEG不能定位的患者中,能够提供有价值的补充信息.     

70例2型糖尿病患者周围神经电生理检查结果分析

糖尿病性周围神经病变是糖尿病最常见的并发症之一 ,神经传导速度 (NCV)早期即有明显改变。为了进一步探讨糖尿病性神经病变的早期诊断方法 ,我们对 70例临床确诊为 2型糖尿病 (NIDDM)的患者进行了神经电生理检查 ,现报告如下。资料与方法 :70例患者均按 WHO制定的糖尿病标准确诊 ,其中男 38例 ,女 32例 ;年龄 2 9～ 76岁 ,平均 5 2 .5岁 ;病史 3个月至 30年。患者空腹血糖 6 .2～ 2 1.4mmol/ L (正常值4.5～ 6 .1m mol/ L) ,神经系统检查无阳性体征。采用美国 Nicolet Viking IVD型肌电图仪进行检测 ,室温 18～ 2 5℃。患者均行 NC…     

癫痫患者皮层棘波放电与电镜观察

有关癫痫机制的研究,多数是在动物实验中进行,而在人脑上进行研究的报道不多见,我们利用癫痫患者进行外科治疗的过程,探讨癫痫患者棘波放电的物质基础,为癫痫的发病机制提供有价值的资料。资料与方法临床资料:癫痫患者24例,男18例,女6例,年龄从17个月至49岁,平均22岁。初发年龄最小8个月,最大46岁。病程最短1个月,最长28年。发作类型:全身性发作者7例,复杂部分发作者17例,发作次数最少者每月2次,最多者每天十多次。所有患者神经系统均未见阳性体征,但有8例有不同智能低下。CT扫描: