磁共振源成像在非病灶性新皮层癫痫中的应用：附加价值及与颅内脑电图的比较。
Magnetic source imaging in non-lesional neocortical epilepsy: additional value and comparison with ICEEG.
机构信息
Cleveland Clinic Epilepsy Center, Neurological Institute, 9500 Euclid Avenue, Desk S-51, Cleveland, OH 44195, USA.
出版信息
Epilepsy Behav. 2012 Jun;24(2):234-40. doi: 10.1016/j.yebeh.2012.03.029. Epub 2012 Apr 28.
OBJECTIVE
To investigate the utility of magnetic source imaging (MSI) for localizing the epileptogenic zone (EZ) and predicting epilepsy surgery outcome in non-lesional neocortical focal epilepsy (NLNE) patients.
METHODS
Data from 18 consecutive patients with NLNE who underwent presurgical evaluation including intracranial electroencephalography (ICEEG) and MSI were studied. Follow-up after epilepsy surgery was ≥24 months. Intracranial electroencephalography and MSI results were classified using a sublobar classification.
RESULTS
Sublobar ICEEG focus was completely resected in 15 patients; seizure-free rate was 60%. Eight patients showed sublobar-concordant ICEEG/MSI results and complete resection of both regions; seizure-free rate was 87.5%. Seizure-free rate in cases not matching these criteria was only 30% (p=0.013).
CONCLUSIONS
Magnetoencephalography is a useful tool to localize the EZ and determine the site of surgical resection in NLNE patients. When sublobar concordance with ICEEG is observed, MSI increases the predictive value for a seizure-free epilepsy surgery outcome in these patients.
目的
研究磁源成像（MSI）在非病变性新皮层局灶性癫痫（NLNE）患者中定位致痫区（EZ）和预测癫痫手术结果的作用。
方法
研究了 18 例连续接受包括颅内脑电图（ICEEG）和 MSI 在内的术前评估的 NLNE 患者的数据。癫痫手术后的随访时间≥24 个月。颅内脑电图和 MSI 结果采用亚区分类进行分类。
结果
15 例患者亚区脑电图焦点完全切除；无癫痫发作率为 60%。8 例患者显示亚区一致的脑电图/ MSI 结果和两个区域的完全切除；无癫痫发作率为 87.5%。不符合这些标准的病例的无癫痫发作率仅为 30%（p=0.013）。
结论
脑磁图是定位 EZ 和确定 NLNE 患者手术切除部位的有用工具。当观察到与 ICEEG 的亚区一致性时，MSI 增加了这些患者无癫痫手术结果的预测价值。
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