皮层脑电图监测在致痫灶切除术中的应用(附96例报告)

目的 探讨皮层脑电图(ECoG)监测在癫痫手术中指导切除致痫灶的价值.,方法 2005年12月至2008年6月期间,96例难治性癫痫患者在经过详细的术前评估后,进行了手术治疗.术中先切除癫痫病灶,再行描记EcoG,监测异常放电是否消失;若癫痫波仍大量存在,则进一步切除病灶周围的致痫灶,直至EcoG监测异常放电消失或明显减少.结果 术后随访12～44个月.根据Engel疗效分级标准进行疗效评价.Engel Ⅰ级45例,Ⅱ级22例,Ⅲ级17例,Ⅳ级12例.手术有效率达到87.50%.结论 术中应用EcoG监测能大大提高致痫灶空间定位的准确性,有效地指导癫痫的手术.

Electrocorticogram Monitoring in Resection of Epileptogenic Focus: Reports of 96 cases

Objective To explore the value of Electrocorticogram (EcoG) monitoring in resection of epileptogenic focus. Methods From December 2005 to June 2008, 96 patients with intractable epilepsy received operations after careful preoperative evaluation. During the operation, we resected the epileptic lesions firstly and then recorded ECoG to monitor whether abnormal discharges were disappeared. When the spike waves still existed, epileptogenic focus around the lesions needed to be resected until abnormal discharges disappeared or decreased significantly. Results The patients were followed up 12 ～ 44 months after surgery. The operation efficacy was evaluated by Engel classification standards. Forty five cases had results corresponding to Engel class Ⅰ , 22 cases Engel class Ⅱ , 17 cases Engel class Ⅲ, 12 cases Engel class Ⅳ. The efficiency achieved to 87.50%. Conclusions EcoG monitoring in epilepsy surgery may greatly improve the accuracy of spatial localization of epileptogenic focus, and therefore guide the epileptic operation efficiently.