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目的分析皮质电刺激在功能区致灶手术中的应用。方法回顾性分析8例功能区难治性癫病人的临床资料。根据视频脑电图及电刺激结果,确定致灶与功能区之间位置关系,术中保护功能区,最大程度切除致灶。结果手术顺利,术后2例左额叶软化灶病人术前肌力4级,术后无肌力下降;1例右枕叶皮质发育不良病人,术后视野部分缺损。随访6个月~3年,6例病人无癫发作,2例病人发作减少90%。Engel分级Ⅰ~Ⅱ级。结论皮质电刺激是定位大脑功能区的金标准,应用皮质电刺激治疗功能区癫可以在保留功能区的基础上最大程度切除致区,提高癫病人生活质量,更好地控制癫。
Objective To analyze the application of cortical electrical stimulation in foci induced by functional area. Methods The clinical data of 8 patients with refractory epilepsy in functional areas were retrospectively analyzed. According to the video electroencephalogram and electrical stimulation results, to determine the location of the relationship between the stovepipe and the functional area, intraoperative protection of functional areas, the maximum extent of excision caused by stovepipe. Results The operation was successful. The postoperative anterior muscle strength was 2 in 2 patients with left frontal lobe sclerosis and no decrease in muscle strength after operation. One patient with cortical dysplasia on the right occipital lobe was partially deficient in the postoperative visual field. Six months to three years follow-up. Six patients had seizures without epilepsy, and two patients had seizures reduced by 90%. Engel grade Ⅰ ~ Ⅱ grade. Conclusions Cortical electrical stimulation is the gold standard for locating brain functional areas. The application of cortical electrical stimulation to functional area epilepsy can maximize the removal of palliative area on the basis of preserving functional areas, improve the quality of life of epilepsy patients and better control of epilepsy .