Clinical Diagnosis Value of Video-electroencephalography and MRI on Pharmacal Intractable Epilepsy_West China Medical Journal

Authors：

LI Mingying ¹ , NI Yan ² ,  DENG Kaihong ³

1. Department of Radiology; 2. Department of Neurosurgery, 416 Hospital, Nucleus Industrial Portion, Chengdu, Sichuan 610051, P. R. China; 3. Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

DENG Kaihong, Email: cl4065@sina.com

Keywords：

药物难治性癫痫; 视频脑电图; MRI; 诊断

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【摘要】　目的　探讨用视频脑电图和MRI诊断药物难治性癫痫的临床价值。　方法　收集2006年12月-2010年5月间经手术和病理证实的药物难治性癫痫患者38例。其中，海马硬化25例，颞叶萎缩伴脑发育不良2例，脑灰质移位及巨脑回4例，血管畸形3例，胶质瘤2例，脑内囊肿1例，外伤性癫痫1例。用视频脑电图监测癫痫发作期及发作间期痫样放电的来源部位及脑电活动特点，用MRI扫描显示痫灶区的表现特征，并与手术、病理改变对照，进行回顾性分析。　结果　视频脑电图对癫痫发作期的致痫灶来源定位准确率为100%（38/38），发作间期定位准确率为53%（20/38）。MRI对发作间期的致痫灶及相关病变定位诊断准确率为89%（34/38），病变定性准确率为79%（30/38）。　结论　视频脑电图和MRI检查有机结合，对药物难治性癫痫，能更有效检出致痫灶的部位及性质，为药物难治性癫痫患者的手术治疗，提供重要信息。
【Abstract】　Objective　 To study the clinical diagnosis value of video-electroencephalography (EEG) and MRI on pharmacal intractable epilepsy.　Methods　 From December 2006 to May 2010, 38 cases of pharmacal intractable epilepsy were confirmed through operation and pathologic examination. Among them, there were 25 cases of hippocampal sclerosis, 2 cases of temporal lobe atrophy combined with brain dysplasia, 4 cases of heterotopic gray matter and macrogyria, 3 cases of vascular malformation, 2 cases of glioma, 1 case of cyst in brain, and 1 case of traumatic epilepsy. Video-EEG was applied to monitor the source of epileptoid discharge and the features of brain electrical activity during and between the occurrences of epilepsy. MRI was used to detect the manifestation characteristics of the epilepsy focus, and retrospective analysis was done to compare these findings with operational and pathological results.　Results　 The accuracy rate of Video-EEG in locating the epilepsy focus was 100% (38/38) during the occurrence of epilepsy, and 53% (20/38) between the occurrences of epilepsy. The accuracy rate of MRI in diagnosing the epilepsy focus and relevant abnormalities during the occurrence of epilepsy was 89% (34/38), and 79% (30/38) in characterizing the abnormalities.　Conclusion　 Video-EEG combined with MRI examination is effective in locating and characterizing the epilepsy focus, which can provide more useful information for the surgery in treating pharmacal intractable epilepsy.

Citation： LI Mingying,NI Yan,DENG Kaihong. Clinical Diagnosis Value of Video-electroencephalography and MRI on Pharmacal Intractable Epilepsy. West China Medical Journal, 2011, 26(10): 1517-1520. doi: Copy

1.	中华医学会. 临床诊疗指南癫痫病分册[M]. 北京: 人民卫生出版社, 2007: 1-61.
2.	李良, 曾义军, 陈建斌, 等. 难治性癫痫不同类型手术预后与病程的相关关系分析[J]. 华西医学, 2011, 26(2): 201-203.
3.	王志群, 李坤成, 王亮, 等.颞叶癫痫定位诊断的磁共振波普研究[J]. 放射学实践, 2007, 22(4): 371.
4.	何慧瑾, 沈天真, 陈星荣, 等. MRI海马结构体积分割分析对颞叶癫痫的诊断价值及临床相关性研究[J]. 中华放射学杂志, 2004, 38(12): 1285.
5.	Stephen LJ, Kelly K, Mohanraj R, et al. pharmacological outcomes in older people with newly diagnosed epilepsy[J]. Epilepsy Behav, 2006, 8(2): 434-437.
6.	王蕊, 李飒英, 谭晔, 等. 药物难治性癫痫MRI表现与脑电图及病理对照研究[J]. 中国神经免疫学和神经病学杂志, 2009, 16(2): 116-117.
7.	李月峰, 姜平, 王冬青, 等. 青年人与老年人海马体积及形态的MR研究[J]. 中华放射学杂志, 2009, 43(12): 1281-1285.
8.	周晓娟, 孙波, 戴建平, 等. MR表观扩散系数值在海马硬化术前评定中的价值[J]. 中华放射学杂志, 2004, 38(12): 1277-1280.
9.	孙吉林, 吴杰, 贾秀川, 等. 磁源性影像在灰质异位症伴癫痫患者癫痫灶定位中的应用[J]. 中华放射学杂志, 2011, 45(1): 44-45.
10.	申广浩, 罗二平, 路丽华, 等. PET、VEEG、MRI癫痫灶定位与病理一致性的研究[J]. 中国医学物理学杂志, 2008, 25(1): 482-483.
11.	陈子怡, 周列民. 药物难治性癫痫发病机制研究进展[J]. 国外医学•内科分册, 2006, 33(4): 182.
12.	Daniel RT, Thomas SG, Thomas M. Role of surgery in pediatric epilepsy [M]. Indian Pediatr, 2007, 44(4): 263-273.

1. 　中华医学会. 临床诊疗指南癫痫病分册[M]. 北京: 人民卫生出版社, 2007: 1-61.
2. 　李良, 曾义军, 陈建斌, 等. 难治性癫痫不同类型手术预后与病程的相关关系分析[J]. 华西医学, 2011, 26(2): 201-203.
3. 　王志群, 李坤成, 王亮, 等.颞叶癫痫定位诊断的磁共振波普研究[J]. 放射学实践, 2007, 22(4): 371.
4. 　何慧瑾, 沈天真, 陈星荣, 等. MRI海马结构体积分割分析对颞叶癫痫的诊断价值及临床相关性研究[J]. 中华放射学杂志, 2004, 38(12): 1285.
5. 　Stephen LJ, Kelly K, Mohanraj R, et al. pharmacological outcomes in older people with newly diagnosed epilepsy[J]. Epilepsy Behav, 2006, 8(2): 434-437.
6. 　王蕊, 李飒英, 谭晔, 等. 药物难治性癫痫MRI表现与脑电图及病理对照研究[J]. 中国神经免疫学和神经病学杂志, 2009, 16(2): 116-117.
7. 　李月峰, 姜平, 王冬青, 等. 青年人与老年人海马体积及形态的MR研究[J]. 中华放射学杂志, 2009, 43(12): 1281-1285.
8. 　周晓娟, 孙波, 戴建平, 等. MR表观扩散系数值在海马硬化术前评定中的价值[J]. 中华放射学杂志, 2004, 38(12): 1277-1280.
9. 　孙吉林, 吴杰, 贾秀川, 等. 磁源性影像在灰质异位症伴癫痫患者癫痫灶定位中的应用[J]. 中华放射学杂志, 2011, 45(1): 44-45.
10. 　申广浩, 罗二平, 路丽华, 等. PET、VEEG、MRI癫痫灶定位与病理一致性的研究[J]. 中国医学物理学杂志, 2008, 25(1): 482-483.
11. 　陈子怡, 周列民. 药物难治性癫痫发病机制研究进展[J]. 国外医学•内科分册, 2006, 33(4): 182.
12. 　Daniel RT, Thomas SG, Thomas M. Role of surgery in pediatric epilepsy [M]. Indian Pediatr, 2007, 44(4): 263-273.

West China Medical Journal

Clinical Diagnosis Value of Video-electroencephalography and MRI on Pharmacal Intractable Epilepsy

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