Zhang Ning, Qiao Hui, Wang Yong-Jun, Sun Bo, Feng Yi-Gang, Shu Ning
Epilepsy Center, Beijing Tiantan Hospital, Capital University of Medical Sciences, Beijing 100050, China.
Zhonghua Nei Ke Za Zhi. 2007 May;46(5):370-2.
To explore the clinical application value and feasibility of magnetoencephalography (MEG) in the localization of epileptogenic zone, as compared with scalp electroencephalography.
69 patients were enrolled in this study, all the patients were examined with MEG and scalp EEG and received operative treatment. During the operation the patients underwent ECoG and deep EEG monitoring and after the operation the follow-up continued 2 - 3 years. Results were evaluated with Engel curative effect grading.
Among the 69 patients there was 62 patients whose localization were limited to one lobe with MEG; while only 30 with EEG. We used Engels, grading to define the effectiveness of the operation. 57 among the 69 patients had effective results with an effective rate of 82.61%. When the lateralization of epileptogenic zone in these 57 patients was counted, the concordance rate of preoperative MEG and EEG with intraoperative EEG was 92.98% (53/57) and 33.33% (19/57) respectively with significant difference between MEG and EEG statistically (chi(2) = 30.250, P = 0.000). The scalp EEG of 34 patients with temporal lobe epilepsy showed bilateral temporal lobe epileptiform discharges or generalized spikes, while the epileptogenic foci were shown with MEG only unilaterally and confirmed by operation finally.
MEG shows significant value in the lateralization of epileptogenic zone of temporal lobe epilepsy. MEG, with a higher time resolution and space resolution, can help to identify epileptogenic zone and mirror foci. MEG can clarify the spatial relationship between the irritative zone and structural lesions or functional areas.
探讨脑磁图（MEG）在癫痫灶定位中的临床应用价值及可行性，并与头皮脑电图进行比较。
本研究纳入69例患者，所有患者均接受MEG和头皮脑电图检查并接受手术治疗。术中对患者进行皮层脑电图（ECoG）和深部脑电图监测，术后随访2 - 3年。采用Engel疗效分级评估结果。
69例患者中，MEG定位局限于一个脑叶的有62例；而脑电图仅为30例。我们采用Engels分级来定义手术效果。69例患者中有57例手术效果良好，有效率为82.61%。对这57例患者癫痫灶的定侧情况进行统计，术前MEG与术中脑电图的一致性率为92.98%（53/57），脑电图与术中脑电图的一致性率为33.33%（19/57），MEG与脑电图之间差异有统计学意义（χ² = 30.250，P = 0.000）。34例颞叶癫痫患者的头皮脑电图显示双侧颞叶癫痫样放电或广泛性棘波，而MEG仅显示单侧癫痫灶，最终经手术证实。
MEG在颞叶癫痫癫痫灶定侧方面显示出显著价值。MEG具有较高的时间分辨率和空间分辨率，有助于识别癫痫灶和镜像灶。MEG能够明确刺激区与结构病变或功能区之间的空间关系。
