Smith S J, Andermann F, Villemure J G, Rasmussen T B, Quesney L F
Department of Neurology and Neurosurgery, McGill University, Montreal, PQ, Canada.
Neurology. 1991 Nov;41(11):1790-4. doi: 10.1212/wnl.41.11.1790.
We reviewed the prognostic significance of preoperative EEG findings in 25 patients who underwent functional hemispherectomy. Bilateral independent epileptogenic foci, found in five patients, generally indicate a less satisfactory outcome, with only three of the five patients becoming seizure free following hemispherectomy. In contrast, abnormalities of background activity over the "good" hemisphere, multifocal epileptic activity confined to the side of operation, or bilaterally synchronous discharges were associated with a good outcome and should not be considered as contraindications to operation. Postoperatively, discharges may occur in the functionally isolated frontal and occipital cortex, which are benign, with no other clinical significance than showing that the isolated cortex remains viable and continues to generate epileptogenic potentials.
我们回顾了25例行功能性大脑半球切除术患者术前脑电图检查结果的预后意义。在5例患者中发现的双侧独立致痫灶，通常提示预后较差，这5例患者中只有3例在大脑半球切除术后无癫痫发作。相比之下，“健侧”半球背景活动异常、局限于手术侧的多灶性癫痫活动或双侧同步放电与良好预后相关，不应被视为手术禁忌证。术后，放电可能出现在功能孤立的额叶和枕叶皮质，这是良性的，除了表明孤立的皮质仍存活并继续产生致痫电位外，没有其他临床意义。
