| 额叶癫痫致痫病灶定位及手术治疗的临床研究 |
| 投稿时间：2010-02-20 修订日期：2010-03-20 点此下载全文 |
| 引用本文：李新宇,魏明海,尹剑.额叶癫痫致痫病灶定位及手术治疗的临床研究[J].医学研究杂志,2010,39(6):104-106 |
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| 中文摘要:目的分析额叶癫痫的临床发作的症状学特征及脑电图特点, 探讨额叶癫痫的病灶定位及手术治疗。方法对30例额叶癫痫患者进行视频脑电图长程监测, 并对其中12例患者施行颅内皮质电极记录脑电图。分析癫痫发作的临床表现及脑电图特点,定位致痫灶, 行手术切除。术中采用脑皮质电极(ECoG) 探测定位,选用或联用胼胝体切开术(CCS),局部痫灶切除及多软膜下横纤维切断(MST) 。结果额叶癫痫的发作临床症状学表现与癫痫病灶有临床关联，结合VEEG监测可发现特征性脑电活动，颅内电极记录可进一步精确定位致痫病灶，30 例额叶癫痫患者经上述2～3种方法联合治疗后随访1年以上，疗效满意。结论观察临床症状学及颅内电极记录有助于揭示其脑电活动变化。对于难治疗性额叶癫痫, 准确定位致痫灶是手术成功的关键。 |
| 中文关键词:癫痫 额叶 视频脑电图 颅内电极 |
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| The Pre-surgical Localization and the Surgical Treatment of Frontal Lobe Epilepsy |
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| Abstract:ObjectiveTo analyze the semiology and the data of monitoring VEEG, and to evaluate the localization and surgery for frontal lobe epilepsy. MethodsVEEG monitoring was performed in 30 patients(frontal lobe epilepsy). Intraoperative electrocorticography ( ECoG)was combined in 12 of them. After the clinical semiology and EEG results were analyzed,the epileptogenic zone was localized,and epileptogenic zone resection surgery was performed in all patients. During the surgery, Intraoperative electrocorticography (EcoG) was applied to detect and localize the epileptogenic zone，and Corpus callostomy(CC) and multiple subpia transection(MST)was also applied. ResultsClinical semiology of frontal lobe epilepsy was correlated with the site of epileptogenic zone. Combined with ictal semiology,VEEG could record the characteristic epileptic waves，but intracrainial electrodes could localize the epileptogenic zone more precisely. 30 frontal lobe epilepsy patients were followed up for at least 1 year after being treated with two to three methods mentioned aboved,and the outcome was satisfactory. ConclusionObserving patient’s ictal semiology and analysing ECoG recordes are very useful for investigating changes of brain electrical wave. For intractable frontal lobe epilepsy，accurately localizing the epeileptogenic zone is the key of a successful surgery. |
| keywords:Epilepsy Forntal lobe VEEG Intracrainial electrodes |
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