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目的探讨颅内电极置入术在临床的应用时机、方法,评估头皮视频脑电图(scalp EEG,sEEG)与颅内电极脑电图(intracranial EEG,iEEG)两者监测技术在癫痫外科中的价值。方法对47例难治性癫痫患者,术前行头皮视频脑电图监测初步确定致痫灶部位,在参考非侵入性评估结果的基础上,采用颅内电极置入、长程脑电图监测技术进行致痫区定位,然后切除致痫灶。结果手术后致痫灶切除效果:EngelⅠ级29例,Ⅱ级10例,Ⅲ级7例,IV级1例。术后发生头皮脑脊液漏3例,修补缝合并延长拆线时间后愈合。1例出现少量硬膜外血肿,保守治疗后血肿吸收。无感染及死亡病例。结论头皮视频脑电图与颅内电极置入并进行长程脑电图两者监测是准确定位致痫区的一种有效、安全的方法。
Objective To investigate the clinical application of intracranial electrode implantation in patients with epilepsy, and to evaluate the clinical application of intracranial EEG (iEEG) and scalp EEG (sEEG) value. Methods Forty-seven patients with refractory epilepsy were screened by video-electroencephalography before surgery to determine the location of the epileptic foci. Based on the non-invasive evaluation results, the intracranial electrodes and long-range EEG monitoring Epilepsy area for positioning, and then excise epileptogenic lesions. Results The resection effect of epileptogenic zone after surgery was 29 cases of Engel Ⅰ, 10 cases of Ⅱ, 7 cases of Ⅲ and 1 case of IV. 3 cases of postoperative scalp cerebrospinal fluid leakage occurred, repair suture and prolong stitches time after healing. One case showed a small amount of epidural hematoma, conservative treatment of hematoma absorption. No infection and deaths. Conclusion Scalp video EEG and intracranial electrode placement and long-range EEG monitoring of both accurate positioning of epileptogenic zone is an effective and safe method.