颞叶癫痫脑电发作起始形式在癫痫灶定位的价值

【目的】 探讨脑电图(EEG)发作起始形式对颞叶癫痫(TLE)患者进行癫痫灶定位的临床价值。【方法】 分析52例确诊为TLE并行手术治疗的患者共273次发作的发作期EEG。所有患者术前均行长程视频脑电图(V-EEG)检查及头颅磁共振(MRI)检查,术中均行皮层脑电图(ECoG)监测进一步定位癫痫灶并在其指导下完成手术,且术后在最少1年的时间内Engel术后效果评估为1级。根据MRI检查结果将52例患者分为海马硬化组、非海马硬化组两组进行对比。 【结果】 通过分析发作起始头皮EEG形式结合MRI检查,MRI提示分入海马硬化组的患者癫痫灶定位率达89.7%,以θ节律、δ节律为能定位的主要脑电发作起始形式。 【结论】 TLE发作期EEG在癫痫灶定位中具有重要作用,特别是记录分析发作起始期的脑电活动能提供更多更准确的定位信息。

Evaluation of Onset Types of Ictal EEG for Localization of Temporal Lobe Epilepsy

【Objective】 To investigate the clinical significance of the EEG onset types for the localization of temporal lobe epilepsy.【Methods】 A total of 273 video-electroencephalogram recordings from 52 patients who were diagnosed with temporal lobe epilepsy. Patients were estimated by long-term video electroencephalogram and magnetic resonance image, and received surgeries, were retrospectively analyzed. All patients with electrocorticogram performed during surgery to localizing epileptic foci. And whose surgical results proved to be Engel class 1 for more than one year after the surgery were enrolled. According to the MRI results, 52 patients were divided into Hippocampal sclerosis group, Non-Hippocampal sclerosis group. 【Results】 The localization of temporal lobe epilepsy can be correctly localized on 64% of tested patients, especially for the patients with hippocampal sclerosis. θ and δ rhythms onsets are the most common onset types of temporal lobe epilepsy. 【Conclusion】 The EEG onset types may have a potential localization diagnosis value in different pathologic temporal lobe epilepsy.