摘要
目的研究非病灶性新皮质癫痫发作间期脑磁图（MEG）与手术切除范围一致性与预后的关系。方法25例非病灶性新皮质癫痫，术前行发作间期MEG检测以及颅内视频脑电监测（i—VEEG），术后随访1年以上并运用Engel法评价预后。结果术后总体无发作率（EngelIA）36％（9／25）、有效率（Engel Ⅰ级、Ⅱ级）68％（17／25）。14例MEG与手术切除范围一致组术后8例无发作，无发作率57％（8／14），有效率71％（10／14）；11例不一致组，术后无发作率9％（1／11），有效率64％（7／11），一致组术后无发作率优于不一致组（P〈0．05）。结论非病灶性新皮质癫痫发作间期MEG与手术切除范围一致与术后无发作率有明确相关性。
Objective To investigate whether interictal magnetoencephalography （MEG） consistent with surgical range could predict the surgical outcomes in patients with nonlesional refractory neocortical epilepsy（NE）. Methods Twentyfive patients with nonlesional NE were studied. All patients had longterm intracranial video - eleetroencephalography （ i - VEEG） monitoring and MEG examinations before surgery. According to the relationship between localization of interictal MEG and surgical range, we divided the participants into two groups, including concordance condition （MEG findings were concordant with surgical range） and discordance condition （MEG findings were discordant with surgical range）. Epilepsy surgery was performed to the 25 patient. The surgical outcomes were assessed by neurosurgeons based on over one - year follow - up after surgery using the Engel classification system. Results The total seizure - free （Engel class IA） rate was 36% （9/25）, and the total effective rate was 68% （17/25）. The seizure - free rate of concordance condition was 57% （ 8/14 ）, and effective rate was 71% （ 10/14 ）. The seizure - free rate of discordance condition was 9% （ 1/11）, and effective rate was 64% （ 7/11 ）. Both the seizure - free rate and effective rate of concordance group were significantly better than those of discordance condition. A statistical difference was found between the seizure - free outcomes of patients with concordance condition and with discordance condition （ P 〈 0.05 ）. Conclusions The study demonstrates that a favorable post - surmcal outcome could berodicted in most patients with concordance of MEG and sumical range.
出处
《中华神经外科杂志》
CSCD
北大核心
2012年第11期1150-1153,共4页
Chinese Journal of Neurosurgery
基金
南京市市医药卫生科研课题（NO.YKK11033）,南京市科学技术局资助项目（NO.2009sc334005）
关键词
脑磁图
癫痫手术
新皮质癫痫
非病灶性
iMagnetoencephalography
Epilepsy surgery
Neocortical epilepsy
Nonlesional
