颅骨修补围手术期癫痫灶的脑电研究

目的:研究颅骨缺损与外伤性癫痫(PTE)的关系。方法:随机对33例重型颅脑外伤后颅骨修补术病人围手术期多形式脑电图(EEG)进行了前瞻性研究。结果:33例中术前28例EEG局灶性异常,术中皮层脑电图(ECoG)31例有痫样放电。29例癫痫灶全切除,2例因癫痫灶位于功能区仅行部分切除。术后31例无癫痫发作,2例仍有癫痫发作,但较术前减轻,近期效果良好。结论:本研究结果提示,颅骨修补围手术期应常规作多形式EEG及术中ECoG监测,发现癫痫灶时尽可能切除,可望降低颅骨修补术后PTE的发生率。

The EEG study of post-traumatic epileptogenic foci during intraoperative and perioperative period of cranioplasty

To study the relationship between the cranial defects and post-traumatic epilepsy (PTE). Method: 33 patients of large traumatic cranial defect were randomly studied with elec-troencephalography ( EEG ) and eletrocor-ticography (ECoG) during intraoperative and perioperative period of cranioplasty. Result: 28 patients were showed local abnormal pattern on EEGs, and 31 cases were found local epileptic-like waves on ECoG. Under the monitoring of ECoG,the epileptic foci of 29 cases were totally resected and 2 cases were partially resected. The following-up study revealed that the epileptic attack of the former group were cured and the later 2 cases were improved. Conclusion:The epilepto-genic focus EEG and ECoG study were very helpful to detect the epileptic focus during the repairment of cranial defect. If the epileptogenic focus was resected, the frequency of PTE attacks would be reduced.