术前和术后脑电图在预测功能性大脑半球切除术癫痫控制效果中的意义-《临床神经外科杂志》

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Title:: Analysis of the prognostic signficance of EEG before and after functional hemispherectomy

摘要:: 目的探讨功能性大脑半球切除术患者术前、术后脑电图与预后的关系。方法回顾性分析20例功能性大脑半球切除术患者术前间期、发作期脑电图及术后脑电图特征，并分析其与预后的关系。结果术后癫痫控制情况：19例（95%）Engel I级，1例（5%）Engel III级。以术后是否存在癫痫发作作为预后评价指标（术后急性期癫痫发作除外）。共6例（3例Engle Ia级、2例Engle Id级、1例EngleIII级）术后存在癫痫发作。术前脑电图健侧半球慢波增多、间期双侧半球独立痫性放电以及术后脑电图健侧半球痫性放电与术后癫痫发作相关。而术后存在健侧半球放电的患者中，如术后6月内放电消失或演变为患侧半球放电，仍可获得良好预后。结论半球病变性癫痫术前间期脑电图、及术后脑电图对术后癫痫控制效果具有重要的预测的价值。

Abstract:: Objective：To investigate the prognostic significance of pre- and postoperative EEG fandings of patients performed functional hemispherectomy. Methods：Pre- and postoperative EEG of 20 patients who underwent functional hemispherectomy in our hospital from 2005 March to 2013 July, were analyzed retrospectively. All patients followed up for more than 1 year.The characteristics of pre- and postoperative interictal ang ictal EEGs were analyzed ,and their relationship with the prognosis were discussed. Results: 19 cases (95%) were Engle grade I, 1 case (5%) of grade EngleIII. In preoperative EEG, increased slow wave on background of nonpoerated hemisphere, bilaterally independent discharge on interictal EEG, and in ,the postoperative EEG,epileptiform discharge in nonoperated hemisphere were associated with postoperative seizure.However , When epileptiform discharge on nonoperated hemisphere disappeared before six months after surgery, patients can still be in good prognosis. Conclusions: The electroencephalogram before and after functional hemispherectomy has a certain value in outcome prediction. Especially greater predictive value of postoperative EEG.