诱发电位联合皮层脑电监测指导中央区继发性癫疒间的手术治疗

目的:探讨联合应用皮层体感诱发电位(Co-SEP)、皮层运动诱发电位(Co-MEP)及皮层脑电监测(ECoG)对大脑功能区和致疒间灶定位并手术治疗的效果。方法:30例致疒间灶位于大脑中央区及其邻近部位的癫疒间患者,术前通过神经影像、电生理等技术综合评估,术中运用Co-SEP、Co-MEP、ECoG,准确定位致疒间灶及功能区,尽量全切病变及致疒间灶治疗继发性癫疒间,同时保护重要脑功能。结果:对30例患者术后随访6～18个月,根据Engel标准,Ⅰ级18例,Ⅱ级7例,Ⅲ级3例,Ⅳ级2例。所有患者术后均无永久性肢体运动功能障碍。结论:术中联合应用Co-SEP、Co-MEP、ECoG,能安全、准确、有效地指导脑中央区病变及致疒间灶的治疗,在避免运动皮层损伤的同时,最大限度切除病变,提高患者生存质量。

Combined Cortical Evoked Potential and Electrocorticogram Monitoring in Epilepsy Surgery

Objective:To evaluate the effect of surgical treatment by using cortical sensory evoked potential(Co-SEP),motor evoked potential(Co-MEP) and electrocorticogram(ECoG) in epileptogenic focus of central area.Methods:Thirty intractable epilepsy patients with the epileptogenic focus in central area underwent the surgery.The Co-SEP and Co-MEP were performed to detect the motor and sensory areas,and the ECoG was performed to detect the epileptogenic focus.The brain lesions were removed as much as possible,while pr...