| BackgroundsEpilepsy,commonly known as the wind or epilepsy,is a chronic disease of transient brain dysfunction caused by highly synchronous abnormal discharge of brain neurons.Its clinical manifestations have the common characteristics of seizure,transience,repetition and rigidity.The clinical manifestations of epileptic seizures are complex and varied due to the differences of the initial location,sweep scope and transmission mode of abnormal discharge.Epilepsy has become the second most common neurological disease in China after headache.The onset of this disease is urgent,often close to the doctor,the primary hospital will become the first unit of diagnosis and treatment,due to the repeated onset of the disease,resulting in clinical diagnosis and treatment difficulties.Although about70%-80%of epilepsy patients can be effectively controlled by normal diagnosis,correct classification and rational selection of anti-epileptic drugs,there are still 20%-30%of patients who do not respond to normal anti-epileptic drug treatment,the most common one is temporal lobe epilepsy(TLE),which requires surgical resection to cause epileptic lesion.Magnetic resonance imaging(MRI)and video electroencephalogram(VEEG)are the most commonly used methods to detect epileptic focus in primary hospitals.Part I The value of magnetic resonance imaging in the localization of temporal lobe epilepsyObjectiveTo study the clinical significance of magnetic resonance imaging(MRI)in the diagnosis of epileptic focus in temporal lobe epilepsy(TLE).Methods67 patients with TLE were selected as observation group,and 70 healthy people in the same period were selected as control group.Both groups were examined by routine MRI and~1H-Magnetic resonance spectrum(~1H-MRS).The values of NAA/(Cho+Cr)were compared between the two groups,and the lateral detection rates of TLE induced epilepsy were compared by routine MRI,1H-MRS alone and combined examination were compared.ResultsThe NAA/(Cho+Cr)value of the affected side in the observation group was lower than that of the healthy side,the left side and the right side of the control group,and the NAA/(Cho+Cr)value of the healthy side was lower than that of the left side and the right side of the control group(P<0.05).The detection rate of TLE induced epilepsy lesion in the combined examination of MRI and 1H-MRS was 71.64%(48/67)higher than that in the two groups alone 34.33%(23/67)and 53.73%(36/67),with significant difference(P<0.05).ConclusionsWhen applying MRI brain imaging to the lateral diagnosis of TLE epilepsy focus,we should adopt the combined examination of conventional MRI and 1H-MRS,which can effectively improve the detection rate,help to judge the condition and provide information support for clinical treatment.Part? The value of magnetic resonance imaging combined with video electroencephalogram in epileptic localizationObjectiveTo explore the value of magnetic resonance imaging(MRI)combined with video electroencephalography(VEEG)in epilepsy localization.MethodsA retrospective analysis of between January 2015 and March 2019 in diagnosis of 82 cases of patients with epilepsy,between the inspection data and results of patients were compared with pathology results analysis,compare MRI joint VEEG of lesion detection rate,to compare MRI joint VEEG epileptic zone localization accuracy.In this experiment,the data of epilepsy patients will be collected twice,and the data will be analyzed twice.ResultsThe accuracy of MRI localization for epileptic lesions was 73.17%(60/82),slightly higher than that of VEEG localization examination 65.85%(54/82),but the difference between the two was small and not statistically significant(P > 0.05).The accuracy of MRI combined with VEEG localization for epileptic lesions was 89.02%(73/82),significantly higher than that of MRI alone or VEEG,and the difference was statistically significant(P < 0.05).ConclusionsMRI and VEEG examination has a good effect,after the joint inspection epileptic zone can be effective for epilepsy in detection and localization,help clinicians to provide evidence for reasonable treatment to patients,and can according to the result of joint observed treatment effect,is the joint inspection methods for epilepsy has high application value,worthy of promotion and implementation.Part ? The clinical value of magnetic resonance imaging combined with video electroencephalogram in DNTObjectiveTo explore the role of MRI combined with VEEG in dysembryoplastic neuroepithelial tumor(DNT),analyzing the characteristics of DNT influence on patients,and observe the imaging and pathological features,diagnosis and treatment after comparing with the results of analysis,in order to observe MRI brain VEEG on embryonic development value of diagnosis and treatment of DNT.MethodsA retrospective analysis was performed on 65 patients with DNT admitted between January 2010 and March 2019,all patients with preoperative accepted MRI(routine MRI,1H-MRS and DCE-MRI)and VEEG examination,It was divided into a joint inspection group and a single test group according to whether or not joint testing was used as the difference,after one year of continuous track,follow-up,observation and clinical manifestations of patients,analysis different localization diagnosis effect prognosis.ResultsOf 65 cases,MRI combined with VEEG group patients within 1 month after seizure frequency(1.02 ± 0.65)and single test group(1.33 ± 0.66)contrast difference is small,do not have statistical significance(P > 0.05),MRI combined with VEEG group after surgery in March(1.43 ± 0.82)and postoperative June(3.26 ± 1.36)number of seizures were significantly lower than single test group(2.03 ± 1.03?4.36 ± 1.38),statistically significant difference(P < 0.05);MRI combined with VEEG group of patients with postoperative 1month(16.65 ± 3.04)?3 months(12.36 ± 2.31)after March in the epileptic seizures time slightly below single test group(17.25 ± 3.25?13.02 ± 2.53),but the difference is small,compared to not statistically significant(P > 0.05),MRI combined with VEEG group seizures after 6 months(6.96 ± 1.37)significantly shorter than single test group(10.69 ±1.98),statistically significant difference(P < 0.05);In postoperative follow-up of 1 year,4cases recurrence in 33 patients with MRI combined with VEEG group,1 case was ineffective,6 cases were improved obviously,the rest of the 22 patients were fully recovered,the effective rate was 84.85%(28/33),32 cases of single test group in 8 cases of patients with recurrence,2 cases of void and 11 cases improved significantly,and the rest of the 11 patients were fully recovered,the effective rate was 66.67%(22/32),visible MRI combined with VEEG significantly higher than the efficient use of single examination,statistically significant difference(P < 0.05).ConclusionsIn the diagnosis and treatment of DNT,MRI combined with VEEG can effectively locate and remove the epileptogenic foci,which has high clinical application value. |
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