Rojo P, Caicoya A G, Martín-Loeches M, Sola R G, Pozo M A
Servicio de Neurocirugía; Hospital de la Princesa, Madrid, 28002, España.
Rev Neurol. 2001;32(4):315-20.
In partial epilepsy with seizures which are resistant to drug treatment, better results may be obtained with surgery. This follows thorough assessment to identify the area of the brain responsible for the origin of the seizures, or the epileptogenic zone (EZ), and show that surgical operation will not cause neurological or cognitive damage which might handicap the patient.
This study analyses the value in diagnosis of electroencephalographic dipoles in delimitation of the EZ in patients with refractory partial epilepsy who are candidates for surgical treatment.
In 43 patients we made EEG recordings whilst at rest with their eyes shut during 15 minutes. The signal was analysed by digital EEG apparatus and a map drawn of cerebral electrical activity based on the maximum average amplitude of the epileptic spikes. The electric dipole equivalent to epileptiform activity between seizures was obtained using the programme for analysis of electroencephalographic sources BESA. The localization of the EZ by means of the dipole was compared with the results of EEG, MR, SPECT and seizure video-EEG using intracranial electrodes.
The results of this study show that the dipole model used is highly sensitive for localization of EZ, and in cases in which the dipole and MR coincided, its sensitivity is similar to that of video-EEG during seizures.
The model of dipole used in this study is of great help when indicating surgery for patients with drug-resistant epilepsy.
在药物治疗难治性的部分性癫痫中，手术可能会取得更好的效果。这需要经过全面评估，以确定引发癫痫发作的脑区，即致痫区（EZ），并证明手术不会导致可能使患者致残的神经或认知损伤。
本研究分析脑电图偶极子在界定适合手术治疗的难治性部分性癫痫患者的致痫区时的诊断价值。
对43例患者在闭眼静息状态下进行15分钟的脑电图记录。信号由数字脑电图仪进行分析，并根据癫痫棘波的最大平均振幅绘制脑电活动图。使用脑电图源分析程序BESA获得发作间期癫痫样活动的等效电偶极子。将通过偶极子定位致痫区的结果与使用颅内电极的脑电图、磁共振成像（MR）、单光子发射计算机断层扫描（SPECT）及发作期视频脑电图的结果进行比较。
本研究结果表明，所使用的偶极子模型对致痫区的定位高度敏感，在偶极子与磁共振成像结果一致的情况下，其敏感性与发作期视频脑电图相似。
本研究中使用的偶极子模型在为难治性癫痫患者指明手术方向时非常有帮助。
