CAJ | 학술논문

目的探讨癫痫起始区(EOZ)和脑内“病灶”间的解剖关系.方法回顾性分析2007年11月~2009年11月手术治疗的358例癫痫患者的临床资料.其中22例经头颅MRI证实脑内有“病灶”,经头皮脑电图和颅内电极脑电图确定了EOZ的患者纳入本研究.测量EOZ和“病灶”间距离,定义其解剖关系为重叠(相距<5 mm)、相邻(<20 mm)、远离(>20 mm).术后对“病灶”行病理学检查.结果 EOZ与脑内“病灶”重叠者4例、相邻者13例、远离者5例.病理学结果示,解剖关系为重叠或相邻者多为血管性病变和颅内肿瘤等患者,远离者多为脑发育不良和脑软化坏死等患者.结论“病灶”的病理性质是影响其和EOZ解剖关系的主要因素,“病灶”所处脑区及癫痫病程的影响不确定(P<0.01).
목적탐토전간기시구(EOZ)화뇌내“병조”간적해부관계.방법회고성분석2007년11월~2009년11월수술치료적358례전간환자적림상자료.기중22례경두로MRI증실뇌내유“병조”,경두피뇌전도화로내전겁뇌전도학정료EOZ적환자납입본연구.측량EOZ화“병조”간거리,정의기해부관계위중첩(상거<5 mm)、상린(<20 mm)、원리(>20 mm).술후대“병조”행병이학검사.결과 EOZ여뇌내“병조”중첩자4례、상린자13례、원리자5례.병이학결과시,해부관계위중첩혹상린자다위혈관성병변화로내종류등환자,원리자다위뇌발육불량화뇌연화배사등환자.결론“병조”적병이성질시영향기화EOZ해부관계적주요인소,“병조”소처뇌구급전간병정적영향불학정(P<0.01).
Objective To explore the anatomical relationship between epileptic onset zones (EOZ) and intracerebral lesions. Methods The clinical data of 358 patients with epilepsy treated in our department from November, 2007 to November, 2009 were analyzed retrospectively. The intracerebral lesions were located by MRI and EOZ were located by Scalp electroencephalogram (EEG) and intracranial EEG monitoring in 22 of 358 patients with epilepsy. The anatomical relationships between EOZ and the lesions were defined as overlap (distance between EOZ and the lesions<5 mm), adjacency (<20 mm) and separation (>20 mm). Results There were the overlap relationships between EOZ and the lesions in 4 patients including 2 patients with angiocavernomas, 1 ganglicytoma and 1 neuroepithelioma, adjacency in 13 including 2 with angiocavernomas, 2 ganglicytomas, 4 cortical dysplasia, 2 gray matter heterotoia (GMH), 1 arteriovenous malformation (AVM), 1 neuroepithelioma and 1 encephalodialysis and separation in 5 including 2 with cortical dysplasia, 1 AVM, 1 GMH and 1 encephalodialysis. Conclusions The pathological nature of the lesions plays an important role in determining the relationship between EOZ and the lesions. The overlap and adjacency relationships between EOZ and the lesions are mostly seen in the patients with cerebrovascular disease or cerebral tumors, and the separation relationship is mostly seen in the patients with cerebral dysplasia or encephalodialysis.