多模态影像结合颅内电极定位致痫灶在癫痫手术中的效果
梁明礼 叶 敏 张文波 杨玉先 刘文浩
梅州市人民医院，广东 梅州 514031
通信作者：梁明礼
【摘要】 目的 探究多模态影像分析结合颅内电极定位致痫灶在症状性癫痫手术中的应用效果。 方法 选取 2018-01—2021-07 梅州市人民医院收治的 37 例症状性癫痫患者，术前均进行多模态影像初步确定致痫灶，根据非侵袭性监测结果进行颅内电极定位致痫灶，并行致痫灶切除手术，观察患者术后疗效及并发症。结果 术后致痫灶切除疗效：EngelⅠ级 29 例（78.38%），Ⅱ级 4 例（10.81%），Ⅲ级 4 例（10.81%），IV 级为 0 例。1 例（2.7%）颞前叶及内侧结构切除术后并发脑水肿，行去骨瓣减压，二期行颅骨修补术，恢复良好；2 例（5.4%）术后出现暂时性单侧肢体偏瘫，术后 2 个月恢复正常；均无颅内出血、感染及死亡发生。结论 多模态影像分析结合颅内电极能帮助症状性癫痫手术中准确定位致痫灶，且术后效果显著，并发症少。
【关键词】 多模态影像；颅内电极；致痫灶；症状性癫痫；并发症
【中图分类号】 R742.1 【文献标识码】 A 【文章编号】 1673-5110 （2022） 04-0443-05
基金项目：梅州市科技计划项目（编号：2015B018）
DOI：10.12083/SYSJ.211681
Effect of multimodal imaging combined with intracranial electrode localization in epilepsy surgery
LIANG Mingli，YE Min，ZHANG Wenbo，YANG Yuxian，LIU Wenhao
Meizhou People’s Hospital，Meizhou 514031，China
Corresponding author: LIANG Mingli
【Abstract】 Objective electrode localization in symptomatic epilepsy surgery. To explore the application of multimodal imaging analysis combined with intracranial Methods Thirty-seven patients with symptomatic epilepsy admitted to our hospital from January 2018 to July 2021 were selected. The epileptic foci were initially determined by multimodal imaging before operation. According to the results of non-invasive monitoring，the epileptic foci were located by intracranial electrodes，and the epileptic foci were resected. The postoperative efficacy and complications were observed. Results The results of epileptogenic foci resection were as follows：29（78.38%） cases in Engel grade Ⅰ，4（10.81%）cases in grade II，and 4（10.81%）cases in grade III. One patient（2.7%） had cerebral edema after resection of the anterior temporal lobe and medial structure，and underwent decompression with bone craniectomy，and underwent second-stage cranioplasty，and turned out to be well recovery. Two （5.4%） patients developed transient unilateral limb hemiplegia after the operation，and returned to normal 2 months after the operation. No intracranial hemorrhage，infection，or death occurred. Conclusion Multimodal imaging analysis combined with intracranial electrode can help to accurately locate the epileptogenic focus in the operation of symptomatic epilepsy，with significant postoperative effect and few complications.
【Key words】 Symptomatic epilepsy；Multimodalimage；Intracranial electrode；Epileptogenicfocus；Complication
