| 摘要: |
| ［摘要］ 目的 探讨难治性癫痫三级脑电监测及显微手术干预的临床效果。方法 对30例难治性癫痫患者进行常规头皮脑电图(EEG)和动态视频脑电图（VEEG）监测，结合CT、MRI、ECT影像表现，进行综合性评估，确定致痫灶；术中皮层脑电图(ECoG)及深部电极脑电图(DEEG)监测癫痫放电区域，麻醉唤醒后，皮层及深部电刺激验证，对孤立性癫痫病灶行显微手术切除，对多灶性或双侧独立的癫痫灶行胼胝体切开术，对位于皮质功能区癫痫灶行软脑膜下横切(MST)。结果 30例难治性癫痫患者术后Engel分级：Ⅰ级19例，Ⅱ级10例，Ⅲ级1例，无Ⅳ级病例。所有患者术后无永久性神经功能缺失，无语言记忆功能障碍。结论 VEEG+MRI+ECT+ECoG或DEEG组合评估，对难治性癫痫致痫灶定位准确，显微手术后疗效良好。 |
| 关键词: 头皮脑电图 动态视频脑电图 皮层脑电图 深部电极脑电图 显微手术 |
| DOI：10.3969/j.issn.1674-3806.2013.06.07 |
| 分类号:R 741 |
| 基金项目:广西卫生厅科研课题（编号：Z2012283） |
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| Assessment of three-level electroencephalography monitor and microsurgery for intractable epilepsy:analysis of 30 cases |
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LAN Sheng-yong, XIAO Qian, XU Peng，et al.
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Department of Neurosurgery, the People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China
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| Abstract: |
| ［Abstract］ Objective To discuss the clinical improvement of three-level electroencephalography monitor and microsurgery for intractable epilepsy.Methods Thirty intractable epilepsy patients were comprehensively evaluated by combining electroencephalography(EEG)/videoelectroencephalography(VEEG) with imaging finding of computer tomography(CT)/magnetic resonance imaging(MRI)/emission computed tomography(ECT), then, the epileptic focus were located, finally, epileptic discharge area were checked by electrocorticalgram(ECoG)/depth electroencephalography(DEEG) and conformed ECoG and DEEG during wake up test. Microsurgical resection were performed for isolated epileptic focus, corpus callosotomy were performed for multifocal or bilateral independent epileptic foci, multiple subpial transectio(MST) were performed for epileptic foci included cortical functional areas.Results Postoperative Engel grade:Ⅰ 19 cases, Ⅱ 10 cases, Ⅲ 1 case, Ⅳ none. There is on permanent nerve function loss reduction in those cases.Conclusion Combining VEEG/MRI/ECT and ECoG(or DEEG), the epileptic focus of intractable epilepsy were accurately located, and satisfactory post-operation outcomes were achieved. |
| Key words: Electroencephalography(EEG) Videoelectroencephalography(VEEG) Electrocorticalgram(ECoG) Depth electroencephalography(DEEG) Microsurgery |
