特集 脳神経外科医が知っておきたい-てんかんのすべて Ⅲ 脳神経外科医が知っておきたい外科的手法による局在診断 焦点切除術における慢性頭蓋内脳波と術中脳波
特集 脳神経外科医が知っておきたい-てんかんのすべて Ⅲ 脳神経外科医が知っておきたい外科的手法による局在診断 焦点切除術における慢性頭蓋内脳波と術中脳波
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专题：神经外科医生需要了解的癫痫一切Ⅲ神经外科医生需要了解的手术技术的定位诊断慢性颅内脑电图和病灶切除术中的术中脑电图
DOI：
10.11477/mf.1436204717
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Maehara T
中科院分区：
文献类型：
--
作者：
Inaji M;Orihara A;Maehara T
与常规脑电成像相比，采用颅内电极的皮质脑电具有更高的空间分辨率和更高的灵敏度。采用带硬膜下栅状电极的慢性视频脑电地形图已被用于确定癫痫灶的切除边界，并在手术前评估皮质功能。有必要记录多次癫痫发作，以确定它们是否与习惯性癫痫发作相同，以及它们是否可重现，以便随后能够识别癫痫发作的起始区。还有必要了解不同癫痫发作时的发作期ECoG模式。最近工程技术的进步使宽带(0.01-600赫兹)分析成为可能。据报道，切除伴有发作期DC移位和高频振荡的区域可以改善手术结果。虽然硬膜下格栅置入术在技术上简单，但已有高发生率的并发症，如感染和出血的报道。术中行急性ECoG检查以确定手术切除范围。总体而言，术中ECoG受麻醉药的影响较大，应仔细评估发作间期的癫痫放电。
Electrocorticography(ECoG)with intracranial electrodes has a higher spatial resolution and higher sensitivity than conventional electroencephagrahy. Chronic VIDEO-ECoG with subdural grid electrodes has been used to determine the resection border of epileptic focus, and to evaluate cortical function prior to resective surgery. Recording multiple seizures is necessary to determine whether they are the same as habitual seizures and whether they are reproducible, to allow subsequent identification of the seizure onset zone. It is also necessary to understand the ictal ECoG patterns of various seizure onsets. Recent advances in engineering technology have made wideband(0.01 Hz-600Hz)analysis possible. The resection of the area with the ictal DC shift and high frequency oscillation is reported to improve surgical outcome. Although the procedure of subdural grid insertion is technically easy, high rates of complications, such as infections and bleeding, have been reported. Intraoperative acute ECoG was used to validate the extent of resection area. Overall, intraoperative ECoG is greatly affected by anesthetics, and the interictal epileptic discharge should be evaluated carefully.