Jennum P J, Andersen A R, Dam M, Fuglsang-Frederiksen A, a-Rogvi Hansen B, Lyon B B, Madsen F F
Klinisk neurofysiologisk afdeling, Hvidovre Hospital, København.
Ugeskr Laeger. 1994 Feb 28;156(9):1285-6, 1289-92.
The aim of the preoperative neurophysiological investigations is to identify the primary epileptogenic focus and its relation to functional cortical areas. The investigations include interictal and ictal extracranial (scalp) electroencephalography (EEG) and invasive methods (depth, subdural, foramen ovale electrodes and peroperative electrocorticography). If an epileptic focus is located in the anterior part of the temporal lobe by the use of scalp EEG, this is normally regarded as sufficient for an anterior lobectomy. However, because of poor spatial resolution by scalp EEG, it is difficult to separate mesial from lateral foci, identify the exact extent of posterior temporal or extra-temporal foci, identify the primary focus in patients with bilateral abnormalities and identify cases with minor scalp EEG-changes. As invasive EEG shows higher spatial resolution and gives an opportunity to evaluate functional areas, invasive EEG has significant advantages in these patients. Use of invasive EEG bears a slightly increased risk and discomfort to the patient, but is necessary in the presurgical evaluation of some patients suffering from medically intractable epilepsy.
术前神经生理学检查的目的是确定原发性癫痫病灶及其与功能性皮质区域的关系。这些检查包括发作间期和发作期的颅外（头皮）脑电图（EEG）以及侵入性方法（深部、硬膜下、卵圆孔电极和术中皮质脑电图）。如果通过头皮脑电图发现癫痫病灶位于颞叶前部，通常认为这足以进行前叶切除术。然而，由于头皮脑电图的空间分辨率较差，很难区分内侧病灶和外侧病灶，确定颞叶后部或颞叶外病灶的确切范围，确定双侧异常患者的原发性病灶，以及识别头皮脑电图变化较小的病例。由于侵入性脑电图具有更高的空间分辨率，并能提供评估功能区域的机会，因此在这些患者中具有显著优势。使用侵入性脑电图会使患者的风险和不适略有增加，但对于一些药物难治性癫痫患者的术前评估是必要的。
