脑磁图结合颅内电极监测在额叶癫痫手术中的作用

目的探讨额叶癫痫发作间期脑磁图（MEG）与颅内电极视频脑电图（iV-EEG）对致痫灶定位的一致性。方法 2009~2012年手术治疗22例额叶癫痫患者,术前行发作间期MEG检测以及iV-EEG监测定位致痫灶。所有患者术后随访1年以上并运用Engel＇s法评价预后。结果本组术后癫痫无发作率（Engel＇s分级IA级）为45.5%（10/22）,有效率（Engel＇s分级I、II级）为68.2%（15/22）。MEG定位与iV-EEG一致的14例中,术后无发作率为57.1%（8/14）,有效率为85.7%（12/14）;MEG定位与iV-EEG不一致的8例中,术后无发作率为25%（2/8）,有效率为37.5%（3/8）。结论 MEG与iV-EEG监测定位致痫灶范围一致时可作为额叶癫痫患者术后较好的一评价指标。

Application of magnetoencephalography and intracranial video electroencephlography to surgery for frontal lobe epilepsy

Objective To investigate whether the epileptogenic focus which was located by interictal magnetoencephalography （MEG） is consistent with that which was located by video eleetroencephalography （EEG） and value of the unity between both of them to predicting surgical outcome in patients with refractory frontal lobe epilepsy （FLE）. Methods The interictal MEG and intracranial video EEG monitoring （i-EEG） were performed before the operation in 22 patients with FLE. The epiletogenic foei which were consistently located by i-EEG and MEG were resected in 14 patients （consistent group） and the epiletogenic foei located by i-EEG were resected in 8 patients （inconsistent group） because the pileptogenic foci located by MEG were inconsistent with those by i-EEG. Surgical outcomes were assessed by Engel classification system 1-3 years after the surgery. Results The effective （Engel class Ⅰ - Ⅱ ） rate （85.7%,12/14） was significantly higher in the consistent group than that （37.5%, 3/8） in the inconsistent group （P〈0.05）. Conclusion It is suggested that the curative effect of the surgery on FLE may be enhanced by the use of i-EEG combined with MEG.