CAJ | 학술논문

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（ ECoG）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FCD Ⅰa型5例，FCD Ⅰb型3例，FCD Ⅰc型5例，FCDⅡa型6例， FCDⅡb型5例。术后随访1～5年，EngelⅠ级9例，Engel Ⅱ级5例，Engel Ⅲ级8例，EngelⅣ级2例。结论联合应用VEEG、MEG和（或） ECoG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。
목적：탐토자공진난이학정병조적치간성국조성뇌피질발육불량적진단화정위방법，제고수술치료효과。방법회고성분석연합응용시빈뇌전도（VEEG）、뇌자도（MEG）급술중피층전겁뇌전도감측（ ECoG）검사，진단、정위병경수술후병리증실위국조성피질발육불량（ FCD）적24례자공진검사음성적난치성전간환자적림상자료。결과24례전간환자행수술치료，병리FCD Ⅰa형5례，FCD Ⅰb형3례，FCD Ⅰc형5례，FCDⅡa형6례， FCDⅡb형5례。술후수방1～5년，EngelⅠ급9례，Engel Ⅱ급5례，Engel Ⅲ급8례，EngelⅣ급2례。결론연합응용VEEG、MEG화（혹） ECoG기술유조우준학진단화정위자공진음성적FCD，제고FCD치난치성전간적수술료효。
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.