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目的探讨以皮质电刺激为基础的语言功能区皮质的定位方法。方法总结11例癫癎灶邻近语言区病人的治疗经验。将格栅状皮质电极覆盖于脑皮质表面,其中Broca区6例,Wernicke区5例;应用皮质电刺激定位出语言功能区8例,阴性3例;功能磁共振显示语言功能区移位2例。在癫癎灶切除过程中,采用局麻2例,术中拔除喉罩2例,常规气管插管全麻7例;术中注意保留具有语言功能的皮质。结果术后出现一过性语言不流利2例,余9例无明显语言功能障碍。术后随访1年以上,EngelⅠ级8例,Ⅲ级2例,Ⅳ级1例。结论采用埋植式颅内电极进行语言皮质功能绘图方法,可较精确地定位癫癎病人的语言功能区。
Objective To explore the cortical localization method based on cortical electrical stimulation. Methods Summarize the treatment experience of 11 patients with epilepsy in adjacent language area. The grid-like cortical electrodes covered the surface of the cerebral cortex, including 6 cases in Broca area and 5 cases in Wernicke area. 8 cases were found with cortical electrical stimulation and 3 cases were negative. FMRI showed two cases . In the epileptic foci removal process, the use of local anesthesia in 2 cases, intraoperative laryngeal mask removal in 2 cases, conventional tracheal intubation in 7 cases of general anesthesia; intraoperative attention to retain the linguistic function of the cortex. Results There was 2 cases of transient postoperative non-fluent language, the remaining 9 cases without obvious language dysfunction. All cases were followed up for more than one year. There were 8 cases of grade Ⅰ Engel, 2 cases of grade Ⅲ and 1 case of grade Ⅳ. Conclusion Implantation of intracranial electrodes for functional cortical mapping can locate the functional linguistic region of epileptic patients more accurately.