美解眠诱发试验在颞叶癫痫术前脑电图监测中的应用

目的 研究美解眠诱发试验对颞叶癫痫患者癫痫发作和脑电图的影响.方法 回顾性分析60例颞叶癫痫患者行前颞叶切除术的术前视频脑电图(VEEG)监测情况,其中美解眠诱发组与对照组各30例,比较两组的VEEG监测时间、监测到的癫痫发作次数、形式和术后癫痫无发作率.同时比较诱发组诱发前后脑电图变化.结果 VEEG监测时间分别为诱发组35 h,对照组56 h,差异有统计学意义.诱发组药物诱发后VEEG监测到99次癫痫发作,包括注药后5 min内71次(71.7%)、6-60 min 18次(18.2%),其中10次(10.1%)诱发后出现与惯常发作不一致的癫痫发作;而对照组记录到102次癫痫发作,其中4次(3.9%)与惯常发作不一致,两组差异无统计学意义.诱发组注药后发作间期痫性放电明显增加,主要放电部位没有明显变化.诱发的发作期脑电图起源部分仍以单侧颞叶为主,与自然发作差异无统计学意义.结论 美解眠诱发不影响颞叶癫痫灶的定位,可用于颞叶癫痫的术前VEEG监测,可明显减少监测时间.

Bemegride-induced test in EEG recording for preoperative localization of temporal lobe epilepsy

Objective To study the effects of bemegride-induced test on seizure attack and epileptofonn discharge on EEG in patients with temporal lobe epilepsy.Methods To retrospectively study the data of preoperative EEG records of 60 patients with anterior temporal lobectomy,including 30 cases in experience group with bemegride-induced test and 30 cases in control group without bemegride-induced test.The differences of EEG recording times,seizure times and types,percentage of postoperative seizure freedom were studied between two groups,and the difference of EEG before and after induced test in experience group was also compared.Results Significant difference was found in EEC recording time: 35h in experience group and 56h in control group.There were 99 bemegride induced seizures in experience group,including 71(71.7%) in 5 minutes after induced test,18(18.2%) in 6-60min,and 10 non-habitual seizures.Also,there were 102 seizures in control group during EEG recording,including 4 (3.9%) non-habitual seizures.Significant difference wasn't found in seizure times and types between two groups.Interictal epileptiform discharge frequency increased,but the localization didn't obvious change after bemegride induced test,and bemegride induced ictal discharges was mainly localized on unilateral temporal lobe which was almost same with habitual seizure.Conclusion Bemegride induced test has no effect on localization of EEG recording for temporal lobe epilepsy.It could be used in preoperative localization for reducing recording time.