在偶极子定位下显微手术治疗难治性癫痫30例临床分析

目的探讨偶极子定位方法在药物难治性癫痫术前致痫灶定位研究中的作用和准确性。方法对30例药物难治性癫痫患者的致痫灶进行术前偶极子定位,术中以皮层及深部电极加以验证,依据验证结果比较继发性癫痫和原发性癫痫偶极子定位的准确性,并对病灶、致痫灶进行手术处理,术后随访并分别比较继发性癫痫和原发性癫痫的手术治疗效果。结果偶极子对继发性癫痫致痫灶定位的准确性要高于原发性癫痫,经卡方检验,x±s=12.470,P=0.001统计学有显著性差异;两者的治疗结果,P=0.143差异没有显著性。结论偶极子定位是一种无创性的致痫灶定位方法,对继发性癫痫术前致痫灶定位准确,手术效果满意;对原发性癫痫或致痫灶多发、弥散,偶极子定位技术存在一定的局限性。

Surgical treatment of refractory epilepsy after the epileptic foci located by DLM(30 cases clinical analysis)

Objective To investigate the effectiveness and accuracy for preoperative localization of epileptic foci of drug refractory epilepsy by dipole localization method.Methods 30 drug refractory epilepsy cases have been studied All examined by DLM for the localization of epileptic foci before operation and the results have been verified by intraoperative cortical and deep electrodes examinzation.We compare the accuracy for localization of epileptic foci by DLM between symptomatic epilepsy cases and primary epilepsy cases,the effectiveness of operation also have been compared according postoperative follow-ups Results The accuracy for symptomatic epilepsy cases is higher according the results examined by chi-square test,(x±s=12.470,P=0.001) the prognosis of the two groups have no difference(P=0.143).Conclusion Dipole localization method is a kind of non-invasive method for the localization of epileptic foci especially accurate for symptomatic epilepsy cases whose prognosis are also satisfied It has limitations for the localization of primary epilepsy and those who have several or diffuse epileptic foci.