【摘要】　目的　 探討用視頻腦電圖和MRI診斷藥物難治性癲癇的臨床價值。　方法　 收集2006年12月-2010年5月間經手術和病理證實的藥物難治性癲癇患者38例。其中，海馬硬化25例，顳葉萎縮伴腦發育不良2例，腦灰質移位及巨腦回4例，血管畸形3例，膠質瘤2例，腦內囊腫1例，外傷性癲癇1例。用視頻腦電圖監測癲癇發作期及發作間期癇樣放電的來源部位及腦電活動特點，用MRI掃描顯示癇灶區的表現特征，并與手術、病理改變對照，進行回顧性分析。　結果　 視頻腦電圖對癲癇發作期的致癇灶來源定位準確率為100%（38/38），發作間期定位準確率為53%（20/38）。MRI對發作間期的致癇灶及相關病變定位診斷準確率為89%（34/38），病變定性準確率為79%（30/38）。　結論　 視頻腦電圖和MRI檢查有機結合，對藥物難治性癲癇，能更有效檢出致癇灶的部位及性質，為藥物難治性癲癇患者的手術治療，提供重要信息。
【Abstract】　Objective　 To study the clinical diagnosis value of video-electroencephalography (EEG) and MRI on pharmacal intractable epilepsy.　Methods　 From December 2006 to May 2010, 38 cases of pharmacal intractable epilepsy were confirmed through operation and pathologic examination. Among them, there were 25 cases of hippocampal sclerosis, 2 cases of temporal lobe atrophy combined with brain dysplasia, 4 cases of heterotopic gray matter and macrogyria, 3 cases of vascular malformation, 2 cases of glioma, 1 case of cyst in brain, and 1 case of traumatic epilepsy. Video-EEG was applied to monitor the source of epileptoid discharge and the features of brain electrical activity during and between the occurrences of epilepsy. MRI was used to detect the manifestation characteristics of the epilepsy focus, and retrospective analysis was done to compare these findings with operational and pathological results.　Results　 The accuracy rate of Video-EEG in locating the epilepsy focus was 100% (38/38) during the occurrence of epilepsy, and 53% (20/38) between the occurrences of epilepsy. The accuracy rate of MRI in diagnosing the epilepsy focus and relevant abnormalities during the occurrence of epilepsy was 89% (34/38), and 79% (30/38) in characterizing the abnormalities.　Conclusion　 Video-EEG combined with MRI examination is effective in locating and characterizing the epilepsy focus, which can provide more useful information for the surgery in treating pharmacal intractable epilepsy.

引用本文： 李明英,倪艷,鄧開鴻. 視頻腦電圖結合MRI檢查對藥物難治性癲癇診斷的價值. 華西醫學, 2011, 26(10): 1517-1520. doi: 復制