视频脑电图在顽固性癫痫中的应用

目的 探讨常规脑电图(REEG)、视频脑电图(VEEG)及MRJ检查在癫痫病的诊断及术前致痫灶评估中的意义。方法 对40例顽固性癫痫病人进行常规脑电图(REEG)、视频脑电图(VEEG)及MRI检测,并进行REEG与VEEG对癫痫诊断及致痫灶的对比研究及VEEG与MRI的对比研究。23例顽固性癫痫施手术治疗,术中应用皮层电极脑电图及深部电极脑电图进一步监测癫痫病灶。结果 40例癫痫患者中REEG异常40例,棘波检出22例,占55％,局灶棘波17例,占42.5％。VEEG异常40例,棘波检出40例,占100％,局灶棘波35例,占87.5％,两组间经统计学比较有显著性差异(x~2=8.901,P<0.05)。MRI异常28例,而VEEG局限异常35例,其中有25例异常病灶与MRI一致(89.3％),2例VEEG异常范围较MRI异常病灶大,但囊括MRI异常病灶部位。1例VEEG异常部位与影像学相反的病例,经EcoG证实致痫灶为VEEG检测的异常部位。12例MRI异常的病例,均检测到明确的棘波放电,7例表现为局灶异常,5例表现为广泛性异常。EcoG定位顶侧与VEEG一致达100％。结论 VEEG对于癫痫诊断及癫痫致痫灶的定位有相当重要的临床价值,优于REEG及影像学。通过临床表现、影像学、功能性检查尤其是VEEG发现的病灶进行联合定位具有更大的价值。

Application of Video - EEG in Intractable Epilepsy

To explore the significance of routing- EEG (REEG), VEEG, MRI in diagnosis of intractable epilepsy and evaluation of presurgical epileptogenic zone. Methods 40 patients with in-tractable epilepsy were checked by REEG, VEEG and MRI, their results were compared with each other. 23 patients who were operated for epilepsy, in the surgery EcoG was further employed to confirm the epileptogenic zone. Results In the 40 patients with intractable epilepsy, the detection rate of the epileptogenic fo-cuses was42.5% ,70% and 87.5% in REEG, MRI and VEEG respectively. There was a significant differ-ence between REEG and VEEG (x2 = 8.901, P < 0.01). In 23 patiets with surgical treatment, seizure lo-calizations by EcoG were completely consistent with those by VEEG, while were 95.6% by MRI. l patient with different focus between VEEG and MRI was consistent with VEEG confirmed by EcoG. Conclusions VEEG may play a important role in the diagnosis of epilepsy and the localization the epileptogenic zong, which was more excellent than others. The combination definition of epileptogenic zone through clinical manifesta-tion, imaging and EEG have a more important value.