目的采用脑电图功能磁共振同步联合的方法,用于局灶性癫痫患者的术前定位。方法11例局灶性癫痫患者,术前行脑电图功能磁共振同步联合检查,观察癫痫发作间期,痫样放电所致的脑活动情况,并结合同步EEG检查结果、术后病理及定期随访的情况对fMRI结果进行分析。结果10例(10/11)患者均在颅内原有病灶周围发现明显的fMRI信号激活区,并与同步EEG检查的痫样放电脑区基本一致。术后病理证实病灶周围存在导致癫痫发作的病理性改变,术后随访证实11例患者均取得满意的手术效果。讨论局灶性癫痫间期痫样放电引起的血氧水平依赖性效应可用于癫痫灶的定位,脑电图功能磁共振同步联合的检查技术结合,可用于局灶性癫痫的术前定位。
Objective To localize the epileptogenic foci of the focal epilepsy preoperational using combined simultaneous electroencephalogram (EEG) and functional MRI (fMRI). Methods The EEG and functional MRI data of 11 focal epileptic patients were acquired by means of simultaneous EEG-monitored functional MRI before surgery. Observed the brain activation caused by interictal epiletiform discharges (IEDs). Analyzed the findings combined with EEG findings, pathology and postoperative follow-up. Results Ten patients (10/11) showed significant activation nearby the original lesion. It was concordant with EEG findings. Pathological confirmed the existence of seizures caused pathological changes. Follow-up confirmed 11 cases of patients have fine surgery effect. Conclusion The BOLD activation of IEDs can be used to localize the epileptogenic foci in focal epilepsy. The simultaneous EEG-fMRI that combines the advantages of two modalities of neuroimaging has the potential for the application in epilepsy research.