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目的通过对难治性癫痫患者脑磁图(magnettoencephalograhpy,MEG)和颅内埋藏电极监测(i-EEG)的对比研究,评价MEG在癫痫灶定位诊断的价值。方法23例癫痫患者均行MEG检查,剥夺睡眠自发磁场采集不少于50分钟,对患者采用颅内埋置硬膜下和(或)深部电极,利用长程视频脑电图(Video-EEG)监测技术及相应分析软件,监测时间几天到十几天,以捕捉到3次以上发作为标准。比较患者发作间期及发作期颅内电极监测异常放电出现的部位与MEG异常放电部位的相关性及其定位诊断意义。结果23例患者中,21例患者的MEG检查结果为阳性,阳性率为91.3%。在这些结果阳性患者中,定位在单侧的为17例,占全部检查患者的73.9%;定位于双层的为4例,占全部检查患者的17.3%;2例患者的MEG检查结果为未见明显异常,占8%。MEG与颅内埋藏电极监测(i-EEG)定位符合率为65%。结论脑磁图监测是一项高灵敏度的无创性癫痫灶定位方法,是癫痫外科术前定位评估中的一项技术突破,为癫痫外科手术提供了有力的依据。
Objective To evaluate the diagnostic value of MEG in the localization of epileptic foci by comparing the magnetoencephalograph (MEG) and intracranial buried electrode monitoring (i-EEG) in patients with refractory epilepsy. Methods Twenty-three patients with epilepsy underwent MEG examination. The spontaneous magnetic fields were deprived of sleep for no less than 50 minutes. The patients underwent intracranial subdural and / or deep electrode implantation and monitored by Video-EEG Technology and the corresponding analysis software, monitoring time from a few days to ten days, to capture more than 3 episodes as the standard. The correlation between the site of abnormal discharge and the location of abnormal discharge in the intercurrent and intracranial electrodes during the onset of the attack were compared. Results Of the 23 patients, MEG was positive in 21 patients and the positive rate was 91.3%. Of these positive patients, 17 were located unilaterally, accounting for 73.9% of all examined patients; 4 were located in double-stratum, accounting for 17.3% of all examined patients; and 2 of the patients had a MEG test result of See obvious abnormalities, accounting for 8%. MEG and intracranial buried electrode monitoring (i-EEG) in line with the rate of 65%. Conclusion EEG monitoring is a highly sensitive and noninvasive method for locating epileptic foci. It is a technological breakthrough in preoperative evaluation of epilepsy surgery and provides a powerful basis for epilepsy surgery.