島葉癲癇（insular epilepsy）臨床上可以表現(xiàn)出類似額葉癲癇、顳葉癲癇及頂葉癲癇的癥狀。島葉癲癇臨床的復(fù)雜性和變異性常常很難判定島葉皮層獨立致癇性的存在,是一些手術(shù)失敗的原因。島葉本身及其與其他潛在致癇區(qū)（epileptogenic zones,EZ）的廣泛聯(lián)系導(dǎo)致癥狀的復(fù)雜多樣和診斷的不確定性甚至誤診,僅憑臨床癥狀診斷島葉癲癇具有挑戰(zhàn)性。顱內(nèi)電極腦電圖（Intracranial electroencephalography,ICEEG）,尤其是立體定向腦電圖（stereo-electroencephalography,SEEG）通過解剖-電生理-臨床模式被用于確認(rèn)島葉皮層放電起源定位致癇灶。但是ICEEG是侵襲性的具有一定風(fēng)險的檢查。而且ICEEG監(jiān)測其最主要劣勢在于空間覆蓋有限,只有有限數(shù)量的電極能夠被置入。腦磁圖（Magnetoencephalography,MEG）,能夠無創(chuàng)性的探測大腦神經(jīng)電磁信號,是一種相對較新的腦功能的檢測技術(shù),腦磁圖與傳統(tǒng)腦電圖（electroencephalography,EEG）相比其具有更高的空間分辨率,與功能核磁共振（function... 

【文章來源】：河北醫(yī)科大學(xué)河北省

【文章頁數(shù)】：118 頁

【學(xué)位級別】：博士

【部分圖文】：

島葉癲癇MEG棘波源定位圖像

圖 2 頭皮 EEG, MRI, MEG, ICEEG 定位致癇區(qū)Fig.2 Localization of epileptogenic zone with scalp EEG, MRI, MEG andICEEG. Ictal scalp EEG showed low amplitude spikes over Sph-L, F7, T5 (Ain patient 19. Preoperative MRI showed no signal abnormalities (B). MEGraw data and tsss data (C). Source localization of MEG data with sECDdemonstrated left insular origination (D). Both interictal (E) and ictal (FICEEG captured epileptic activity arising from the left insula and cingulatgyrus..

圖 1 不同 MEG 方法溯源島葉癲癇致癇區(qū)g. 1 Source localization of epileptogenic zone by two MEG. methodtients with insular epilepsy. MEG raw data and tsss data in patient 10 ) Field contours and source (side view) and sensor waveform (top viw and processed data for another definitive MEG spike originating frofferent source (C); the related field contours and sensor waveforms urce localization by MEG with sECD using approximately 60 minuteta demonstrated two tight dipole clusters, located in the insular opercu). However, source localization by MEG with accumulated source ima HFOs during the above spikes showed local origination in the insula (F)

【參考文獻(xiàn)】：
期刊論文
[1]腦磁圖在島葉癲癇診斷中的應(yīng)用:八例報告并文獻(xiàn)復(fù)習(xí)[J]. 李哲,劉曉云,姚興祺,毛薇,張夏婷,杜薇,樸媛媛,陶蔚,遇濤,吳遜,王玉平,孫偉.  中國現(xiàn)代神經(jīng)疾病雜志. 2014(11)



本文編號：3548794