临床神经外科杂志
臨床神經外科雜誌
림상신경외과잡지
JOURNAL OF CLINICAL NEUROSURGERY
2014年
6期
405-408
,共4页
郭强%朱丹%冯毅刚%王晓%陈俊喜
郭彊%硃丹%馮毅剛%王曉%陳俊喜
곽강%주단%풍의강%왕효%진준희
癫痫%脑磁图%颅内电极脑电图%导航%多模态
癲癇%腦磁圖%顱內電極腦電圖%導航%多模態
전간%뇌자도%로내전겁뇌전도%도항%다모태
epilepsy%megnetoencephalography%intracranial EEG%navigation%multi-model
目的:研究脑磁图( MEG)与颅内电极脑电图( iEEG)联合在癫痫外科治疗中的应用价值。方法应用MEG参与到将行颅内电极埋置患者的术前评估中:根据电-临床症状学、影像学、脑电图、MEG等结果设计出颅内电极埋置方案,进而行颅内电极置入并监测iEEG,捕捉发作期,最终根据定位结果行手术治疗。结果最终成功定位癫痫发作起始区并手术治疗者38例。其中证实为颞叶癫痫( TLE)的16例中,MEG与iEEG定位一致者仅6例,而颞叶以外癫痫( NTLE)22例中两者一致者达16例,两组结果有统计学差异。所有患者术后随访:Engel Ⅰ级28例,Ⅱ级5例,Ⅲ级3例,Ⅳ级2例。结论 MEG运用于NTLE时较TLE有着更高的与iEEG的一致率。区别于视频脑电图、MRI等其它的无创检查,MEG能够对有创的iEEG电极埋置起到额外指导作用。 MEG与iEEG联合,能使电极埋置更合理精确、有针对性,能获得较高的癫痫手术疗效。
目的:研究腦磁圖( MEG)與顱內電極腦電圖( iEEG)聯閤在癲癇外科治療中的應用價值。方法應用MEG參與到將行顱內電極埋置患者的術前評估中:根據電-臨床癥狀學、影像學、腦電圖、MEG等結果設計齣顱內電極埋置方案,進而行顱內電極置入併鑑測iEEG,捕捉髮作期,最終根據定位結果行手術治療。結果最終成功定位癲癇髮作起始區併手術治療者38例。其中證實為顳葉癲癇( TLE)的16例中,MEG與iEEG定位一緻者僅6例,而顳葉以外癲癇( NTLE)22例中兩者一緻者達16例,兩組結果有統計學差異。所有患者術後隨訪:Engel Ⅰ級28例,Ⅱ級5例,Ⅲ級3例,Ⅳ級2例。結論 MEG運用于NTLE時較TLE有著更高的與iEEG的一緻率。區彆于視頻腦電圖、MRI等其它的無創檢查,MEG能夠對有創的iEEG電極埋置起到額外指導作用。 MEG與iEEG聯閤,能使電極埋置更閤理精確、有針對性,能穫得較高的癲癇手術療效。
목적:연구뇌자도( MEG)여로내전겁뇌전도( iEEG)연합재전간외과치료중적응용개치。방법응용MEG삼여도장행로내전겁매치환자적술전평고중:근거전-림상증상학、영상학、뇌전도、MEG등결과설계출로내전겁매치방안,진이행로내전겁치입병감측iEEG,포착발작기,최종근거정위결과행수술치료。결과최종성공정위전간발작기시구병수술치료자38례。기중증실위섭협전간( TLE)적16례중,MEG여iEEG정위일치자부6례,이섭협이외전간( NTLE)22례중량자일치자체16례,량조결과유통계학차이。소유환자술후수방:Engel Ⅰ급28례,Ⅱ급5례,Ⅲ급3례,Ⅳ급2례。결론 MEG운용우NTLE시교TLE유착경고적여iEEG적일치솔。구별우시빈뇌전도、MRI등기타적무창검사,MEG능구대유창적iEEG전겁매치기도액외지도작용。 MEG여iEEG연합,능사전겁매치경합리정학、유침대성,능획득교고적전간수술료효。
Objective To explore the application of magnetoencephalography ( MEG ) combined with intracranial EEG ( iEEG) in epilepsy surgery.Methods MEG was applied to the presurgical evaluation of the intractable epilepsy patients who were underwent intracranial electrodes implant-ation.Implantation plans were designed based on the electrical-clinical semiology,neuroimaging, EEG findings and MEG of the patients, followed by electrodes implantation and long-term monitoring for ictal iEEG.Results Epilepsy surgery was performed in 38 patients by the protocol at last.Of 16 patients with temporal lobe epilepsy ( TLE) , there were 6 whose MEG results were concordant with iEEG, while in 22 non-TLE(NTLE) there were 16,which showed significant difference.After the long-term follow-up, results of seizure control showed 28 cases was Engel ClassⅠ,5 ClassⅡ, 3 ClassⅢand 2 Class Ⅳ.Conclusions There is higher concordance rate between MEG and iEEG in NTLE patients than in TLE patients.Distinguished from other noninvasive examinations like Vedio-EEG, MRI and so on, MEG can provide additional guidance to the electrodes implantation plan.Application of MEG combined with intracranial EEG will make the implantation plan more precise , more pointed, and remarkablely improve the efficiency of the epilepsy surgery.