摘要目的 探讨术中皮层脑电图(ECoG)在颢叶癫痫手术中的应用价值.方法 回顾性分析105例前颞叶切除手术患者的临床资料与ECoG的监测结果,统计对ECoG的影响因素及其对手术疗效的影响.结果 术前ECoG平均监测时间为72 min,结果显示:无异常11例、颢叶或前颞叶局限性放电73例、广泛痫性放电21例;术后ECoG平均监测时间为38 min,结果显示:无异常91例、颞叶后部痫性放电9例、广泛痫性放电5例.年龄与术前EcoG结果无明显相关性;而病程＜5年者术前EcoG痫性放电局限于前颞叶的比率较高,达到83.3%,且与另外两组差异有统计学意义.有6例(5.7%)根据术后ECoG结果行颞叶皮层后部扩大切除.术前ECoG显示痫性放电局限于前颞叶和术后ECoG正常与其他同期结果间的手术疗效差异有统计学意义,提示术后无癫痫发作.结论 颞叶癫痫患者ECoG监测可发现70%的痫波局限于前颞区,术前和术后ECoG监测结果可用于初步判断手术疗效,ECoG监测对颞叶癫痫手术具有一定的应用价值.

abstractsObjective To study the application value of introperative electrocorticography (ECoG)in anterior temporal lobectomy.Methods To retrospectively collect the clinical data and results of introperative ECoG of 105 patients with anterior temporal lobectomy,and analyze the affect factors of ECoG and relationship of results of ECoG and surgical outcomes.Results The average duration for preresective ECoG was 72 min,and results of preresective ECoG included normality in 11 cases,focal epileptiform discharge in anterior or inferior temporal lobe in 73 patients,and diffuse epileptiform discharge in 21 cases.The average time for postresective ECoG was 38 min,and results of preresective ECoG included normality in 91 cases,focal epileptiform discharge in residual temporal lobe in 9 patients,and diffuse epileptiform discharge in 5 cases.Significant difference wasn't found in result of preresective ECoG in different age groups.Patients with short seizure history (＜5 yrs) rendered 83.3% focal epileptiform discharge,which was significant higher than those of the other 2 groups.6 cases underwent extensive resection on the basis of results of postresective ECoG.Patients with focal discharge in preresective ECoG and normality in postresective ECoG presented better surgical outcomes than others' results in ECoG,and the difference was significant.Conclusion 70% patients with temporal lobe epilepsy present focal epileptiform discharger in anterior temporal lobe in introperative EcoG.The results of ECoG could be useful to forcast surgical outcome,therefore ECoG has definite application value in anterior temporal lobectomy.