| 磁共振阴性的局灶性脑皮质发育不良的手术治疗 |
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| 引用本文： | 朱劲龙,李嘉佳,朱海涛,朱旭昌,张锐.磁共振阴性的局灶性脑皮质发育不良的手术治疗[J].临床神经外科杂志,2014(6):412-415. |
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| 作者姓名： | 朱劲龙 李嘉佳 朱海涛 朱旭昌 张锐 |
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| 作者单位： | 210029,南京医科大学附属脑科医院神经外科 |
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| 基金项目： | 江苏省自然科学基金项目 |
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| 摘 要： | 目的探讨磁共振难以确定病灶的致痫性局灶性脑皮质发育不良的诊断和定位方法,提高手术治疗效果。方法回顾性分析联合应用视频脑电图(VEEG)、脑磁图(MEG)及术中皮层电极脑电图监测(ECo G)检查,诊断、定位并经手术后病理证实为局灶性皮质发育不良(FCD)的24例磁共振检查阴性的难治性癫痫患者的临床资料。结果 24例癫痫患者行手术治疗,病理FCDⅠa型5例,FCDⅠb型3例,FCDⅠc型5例,FCDⅡa型6例,FCDⅡb型5例。术后随访1~5年,EngelⅠ级9例,EngelⅡ级5例,EngelⅢ级8例,EngelⅣ级2例。结论联合应用VEEG、MEG和(或)ECo G技术有助于准确诊断和定位磁共振阴性的FCD,提高FCD致难治性癫痫的手术疗效。
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| 关 键 词： | 癫痫 局灶性皮质发育不良 外科治疗 视频脑电图 脑磁图 |
Surgical treatment for negative MRI epileptogenic focal cortical dysplasia |
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| Institution: | ZHU Jin-long, LI Jia-jia, ZHU Hai-tao, et al. (Department of Neurosurgery, Brain Hospital Affiliated to Nanjing Medical University, Nanjing 210029, China) |
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| Abstract: | Objective To investigate the method of diagnosis and localization for negative magnetic resonance imaging （ MRI ） focal cortical dysplasia （ FCD ） , and improve the effects of surgical treatment.Methods The clinical data of 24 patients with diagnosis and localization for negative MRI FCD by video electroencephalogram（VEEG）,magnetoen-eephalography （MEG） and intraoperative electrocorticography （ ECoG ） , and FCD were proved by operation, were analyzed retrospectively.Results 24 patients of epilepsy treated by the operation and pathological reports showed 5 cases of FCD typeⅠa,3 FCD typeⅠb,5 FCD typeⅠc,6 FCD typeⅡa and 5 FCD typeⅡb.The follow up from 1 to 5 years showed Engel Ⅰgrade in 9 cases,Engel Ⅱgrade in 5,EngelⅢgrade in 8 and EngelⅣgrade in 2.Conclusion Combined application of VEEG,MEG and （ or） ECoG technology can accurately diagnose and location for negative MRI FCD, and Increase the operative efficacy of epileptogenic FCD. |
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| Keywords: | epilepsy focal cortical dysplasia surgical treatment VEEG MEG |
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