症状性癫痫致痫灶的精确定位结果与微创手术疗效分析

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1、临床研究•症状性癫痫致痫灶的精确定位结果与微创手术疗效分析张新伟徐如祥周谷兰张冉【播要】目的探讨症状性欣痈患者致痈灶电生理学、MR检査梢确定位结果与微创外科手术疗效。方法分析2004年9月~2006年3月经我院诊治且资料完整的91例症状性嫌痫总者的临床资料及术后随访情况，分析电生理学与MR检査的精确性，评定手术效果。结果电生理检査与MR检查比较，MR检查漏诊率高，而梢确度较好，电生理检査漏诊率低，但误诊率高，精确度差。本组手术满意率为96.70%。结论本组病例应用综合精确定位技术进行致痫灶定位是可靠的。电生理检査结果可以作为判断致痫灶位詈的参考指标，但在缺乏影像学检査支持时.并不足以成为判

2、断致痈灶位置的确定指标。提高MR扫描的分辨率，降低MR汩诊率是必要的。【关後词】症状性嵌痫；电生理学检査；MR检査【中图分类号】R742」【文献标识码】A【文章编号】1671-8925(2007)10-1027-04ResultsforpreciselocalizationofepileptogenicfociofsymptomaticepilepsyandefficacyanalysisofminimallyinvasivesurgeryZHANGXin-wei,XURu-xicmg,ZHOUGu-lgZHANGRan.DepartmentofNeurosurgery.ZhujiangH

3、ospital,SouthernMedicalUniversity.Guangzhou510282,China[Abstract]ObjectiveToexploretheveracityoflocalizationofepileptogenicfocibytheelectrophysiologicalexaminationandMRscanandeffectsofminimallyinvasivesurgeryinpatientswithsymptomaticepilepsy.MethodsTheclinicaldataandpostoperativefollow-upobservati

4、onsof91caseswithsymptomaticepilepsywereanalyzed;thesepatientshadundergonetherapiesforthetreatmentoftheirepilepsyinourhospitalduringSep.,2004andMar.,2006andtheirmedicalrecordswerekeptintact.TheelectrophysiologicalandMRfindingsfortheveracityoflocalizationwerealsoanalyzedandsurgicaleffectswereevaluat

5、ed.ResultsThecomparisonbetweentheelectrophysiologicalexaminationandMRscanfoundthat,thelatterhadahighrateofmisseddiagnosisbutfavorableveracityandtheformerhadalowrateofmisseddiagnosisbutahighrateofmisdiagnosisandpoorveracity.Thesatisfactoryrateinthisstudywas96.70%.ConclusionTheintegratedtechniquesfo

6、rpreciselocalizationofepileptogenicfociarereliable.Resultsoftheelectrophysiologicalexaminationcanberegardedastheindexforreferenceinjudgingthesiteoftheepilqjtogenicfocus,butwithouttheassistanceofimagingexamination,theseresultscannotbeconsideredastheassuredindex・Therefore,itisnecessarytoraisethereso

7、lutionofMRscantocutdowntherateofmisseddiagnosisbyMRscan.[Keywords]Symptomaticepilepsy;Electrophysiologicalexamination;MRexamination癫痫的诊治较为棘手，即便是病因明确的症状性癫痫，也常因致痫灶的位置、范围、性质难以确定,部分病例难以达到理想的治疗效果C长期以来，脑电图被认为是确定致痫灶的“金标