摘要目的 回顾分析皮层脑电图(ECoG)监测下致痫灶切除治疗继发性癫痫的手术情况,探讨ECoG对继发性癫痫的治疗价值.方法 通过术中ECoG监测,对原发灶切除结合外周皮层低功率热灼的方法治疗62例继发性癫痫(其中脑膜瘤15例,胶质瘤18例,海绵状血管瘤15例,蛛网膜囊肿5例,外伤后软化灶5例,表皮样囊肿2例,动静脉畸形2例)的观察,分析ECoG监测在继发性癫痫手术中的意义.结果 术后常规脑电图检查均未见癫痫波,术后无一例死亡或出现新的功能障碍.术后随访10个月-3年,2例尚有部分性发作,但发作频率减少在90%左右,应用抗癫痫药物治疗后未再有癫痫发作.结论 对于颅脑占位性病变合并的继发性癫痫,术中ECoG监测对于指导癫痫灶的处理是必不可少的.

abstractsObjective To retrospectively study the original lesion resection for the treatment of secondary epilepsy with ECoG monitoring daring operations and discuss the value of intraoperative ECoG monitoring. Methods By means of observing the treatment of 62 patients with secondary epilepsy, we analyzed the significance of intraoperative ECoG monitoring in the treatment of secondary epilepsy with the original lesion resection and peripheral cortices fulguration of low energy. Among the 62 cases, 15 patients were meningiomas,18 were gliomas,15 were cavernous hemangiomas,5 were arachnoid cysts, 5 were post-traumatic changes,2 were epidermoid cysts and 2 were arteriovenous malformations. Results There was no epileptic wave in all patients with regular postoperative EEG. 62 patients were survived from the operations without newly occurred malfunction. A follow-up investigation lasting from 10 months to 3 years revealed that there was no epilepsy recurrence in all the patients except for partial epilepsy recurrence in two patients. But their recurrence frequency reduced for about 90% and the epilepsy recurrence was not found in these two patients after the treatment with antiepileptic drugs.Conclusion In the treatment of intracranial occupying lesions accompanied with secondary epilepsy, the monitoring of ECoG during surgery is necessary for the guidance of the original lesion resection.