| purpose: Intraoperative electroencephalography(ECoG)monitoring,as a more commonly used treatment method in neurosurgery,has been widely used in the treatment of neurosurgery.However,the exploration of its therapeutic effects in different fields is still ongoing.Especially for the use of brain tumor in patients with epilepsy,there is a great controversy.The purpose of this study was to compare supratentorial meningiomas,cavernous hemangiomas,and low-grade gliomas,with surgery resection of tumor mass and combined intraoperative cortical electroencephalography(ECoG)monitoring for extended resection or cortical thermotherapy Epilepsy foci,comparing the difference in epilepsy control in patients.Including the patient’s post-discharge epilepsy improvement,operative time,If the ECoG monitoring results are in line with the v EEG flank level as the main comparative study object.To analyze the therapeutic effect of intraoperative cortical EEG monitoring in patients with epilepsy associated with tumors,and to provide reference for improving clinical work.method: Collected 243 patients from June 2014 to June 2017 in Department of Neuroradiology,First Hospital of Jilin University.The patient’s medical history,surgical records,imaging data,and prognosis were analyzed retrospectively.All patients enrolled in the study performed 24-hour long-range electroencephalogram(v EEG)to determine the presence of epileptic waves.All patients were evaluated for postoperative postoperative seizure improvement according to Engel’s grading criteria.Finally,144 patients met the criteria for inclusion.The selected patients were our department professors and associate professor-level neurosurgeons performing surgical operations.The experimental group(cortical EEG monitoring group)placed cortical brain electricity before and after tumor resection to seek and determine the epileptic focus,and evaluated the lesion after determining the focus.Near nerve function,as far as possible to ensure the integrity of important neurological function under the premise of expanding the lesion or extended cortical thermal resection.The control group only resection the tumor.There was no significant difference between the two groups in the use of hemostasis materials and surgical instruments during surgery,and the materials used were the same when the skull was closed.Postoperatively,the improvement of epilepsy after discharge from the two groups of patients,operation time,v EEG and ECoG fixation rate were compared.SPSS18.0 was used for statistical analysis.result: There were 22 cases of cavernous hemangioma,including13 cases of control group(without cortical EEG monitoring).There were 5male patients and 8 female patients,with an average age of 43.15 years.There were 9 patients in the experimental group(percutaneous cortical monitoring).There are 2 males and 7 females with an average age of 35.22.Study results: There was no statistically significant difference in age,tumor location,and operation time between the two groups.The improvement rate of the gliomas with epliepsy in the intraoperative cortical EEG monitoring group was 88.9%,compared with 61.5% in the control group.There was a statistically significant difference in the prognosis of epilepsy between the two groups(P=0.046).There were 44 cases of meningiomas,of which 26 cases(without cortical EEG monitoring).There were 11 male patients and 15 female patients,with an average age of 52.81 years.There were a total of 18 patients in the experimental group(percutaneous EEG monitoring).There are 7 males and 11 females with an average age of 51 years.Results: There was no statistically significant difference in age,tumor location,operation time,and tumor resection in the two groups.The epilepsy improvement rate outcomes of the two groups were 88.9% and 57.7%,respectively.Thedifference was statistically significant(P=0.004).There were 78 low-grade gliomas,of which 38 were in the control group(without cortical EEG monitoring).There were 20 male patients and 18 female patients,with an average age of 37.55 years.There were 40 patients in the experimental group(for cortical EEG monitoring).There are 18 males and 22 females with an average age of 37.08.Study results: There was no statistically significant difference in age,tumor location,and operation time between the two groups.The improvement rate of epilepsy in the two groups was 90% and 68.4%,respectively.The difference was statistically significant(P=0.018).The improvement rate of epilepsy in each group of tumors was statistically significant.It is indicated that the use of ECoG in the operation is beneficial to the control of postoperative epilepsy,and the extension of the overall operation time is not obvious.Conclusions: 1.For patients with supratentorial cavernous hemangioma,meningioma,and low grade gliomas epilepsy,it is necessary to monitor ECoG during surgery.Patients with seizure waves after resection are required to expand without prejudice to important neurological functions.Resection or cortical thermal burn.2.The use of intraoperative ECoG in the resection of supratentorial cavernous hemangioma,meningioma,and low grade gliomas had little effect on operative time.3,the use of v EEG preoperative definitive epilepsy focus on intraoperative ECoG has a possible guiding role. |
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