Preoperative functional assessment of epilepsy patients secondary to cerebral hemisphere atrophy by magnetoencephalogram and diffusion tensor imaging / 中华神经医学杂志

Objective To investigate non-invasive and safe methods for positioning and assessing the functional areas of epilepsy patients secondary to cerebral hemisphere atrophy to reduce postoperative dysfunction.Methods Eight epilepsy patients with cerebral hemisphere atrophy,admitted to our hospital from March 2006 to April 2009,were chosen in our study; magnetoencephalography (MEG) and magnetic resonance diffusion tensor imaging (DTI) were combined to locate the functional areas and assess the functional compensation of these patients.Different surgical methods were adopted according to different results of the patients.All patients were followed up for 12-46 months,averaged 21.6 months.Results MEG could clearly position the cortical sensory,motor,language and visual functional areas of 5 patients,and the other 3 could only be conformed functional areas without clear boundary resulting from their bad cooperation.DTI successfully showed the shape of functional area cortical fibers,which helped the surgery in deciding the extent of resection.Modified hemispherectomy was performed in two patients,multi-lobe resection in five,and temporal lobe resection and hemisphere incision in one; muscles in the contralateral limb of surgery appeared short-term myodynamia weakness and recovery was achieved after rehabilitation exercise.No epileptic seizure was noted in all the patients,enjoying Engle Ⅰ grading.Conclusion Combination of MEG and DTI is a safe,noninvasive method for locating functional areas,could provide security protection for surgical treatment of patients with epilepsy secondary to cerebral hemisphere atrophy.

The study of symptomatology and electroencephalogram in central region diastematia epilepsy / 中华神经科杂志

ObjectiveTo explore the clinic symptom and the characteristics of video,tightly close,intracranial electroencephalogram (EEG) of patients with central region diastematia epilepsy. Methods Retrospective analysis of 9 patients with central region diastematia epilepsy admitted from June,2007 to August,2009.The characteristics of all patients' seizure symptom and EEG manifestation were analyzed using patients' medical history,video and EEG records.ResultsPatients with central region diastematia epilepsy had relatively long sezure history.The duration of seizure was commonly short,with frequent episode and no obvious intelligence impairment.The seizure was often accompanied with the hyperkinesia in the lower limbs.Scalp EEG showed discharges with low amplitude waves in the mean line area.The superhigh amplitude and regular rhythm slow sharp wave could be found in the diastematia cortex EEG.All patients had an Engel Class Ⅰ outcome after surgery.ConclusionThe seizure symptoms are characteristic in the patients with central region diastematia epilepsy,and some special manifestations can be found in different phase,wave amplitude,rhythm,lead array.

The combination application of intracranial buried electrode and cortical electrical stimulation in the excision of the epileptogenic zone in the central zone / 中国神经精神疾病杂志

Objective To investigate the combination application of the intracranial buried electrode and electrical stimulation techniques in excising the epileptogenic zone in the central zone.Methods Seven patients with epileptogenic zone located close to or in the central zone of brain were recruited in the present study.The lone term ECoG monitoring and electrical stimulation of the codex were performed to identify the epileptogenic zone and the central zone of the brain after patients received intracranial electrode implants.The epileptogenic zone was excised with maximum preservation of the cen-tral zone.The patients were follow-up for 6 to 12 months,the outcomes were evaluated based on the Engel's scale and the Karnofsky(KPS)score.Results Seven patients did not experience any seizures and their Engei's and KPS scores were markedly improve after operation.Conclusions Intracranial buried electrodes and cortical electrical stimulation can guide the resection of epileptogenic zone in the central zone.Patients have no seizure and no serious dysfunction after operation and their quality of life was improved markedly.