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Objective: To investigate the video EEG monitoring in the diagnosis of epilepsy, differential diagnosis, classification and surgical treatment of epileptic foci localization in value. Methods: with complete data of 252 patients with clinical onset of symptoms in patients with video-EEG data were analyzed to determine the diagnosis, clear seizure types. Analyzed the clinical onset form of the proposed surgical treatment of 35 patients with refractory epilepsy patients, preoperative, intraoperative and postoperative video-EEG data, combined with the imaging data epileptogenic foci in the preoperative positioning. Results: 1:1.1 episodes: monitoring to clinical onset of a total of 323 of the 133 patients. Combined with a history of seizures performance, ictal and interictal period EEG can see, all cases were divided into: epilepsy group of 193 cases, 45 cases of non-epilepsy group, can not determine the diagnosis of 14 cases. 1:1.2 to determine the type of attack: epilepsy group, detected 88 cases of clinical onset of 237 seizures, simple partial seizures 52, 89 complex partial seizures, partial seizures secondarily generalized seizures 64 times, the typical absence seizures 25 times. Tonic - clonic 7. This group 96 seizures occurred in sleep, more than 141 times sober attack. 88 patients, 21 cases of epilepsy seizures occur only during sleep, 37 cases of sleep and wakefulness have seizures, 30 cases only sober attack. Type of non-epilepsy group attack a total of 86 episodes, nine cases of sleep disorders, tic disorders in children six cases of dystonia after cerebral infarction in 5 cases, 25 cases of pseudo-epileptic seizures. 14 in the group of non-epileptic seizures occur during sleep, are manifestations of sleep disorders, more than 72 episodes occurred in the wake stage. 1:1.3. Confirmation of epilepsy and epilepsy syndrome based on history, seizures performance, interictal and ictal EEG findings can be diagnosed as epilepsy syndromes: benign childhood epilepsy with central temporal spikes 15 cases, childhood absence epilepsy, Lennox-Gastaut syndrome in three cases, a total of 26 cases. To determine the type of epilepsy: frontal lobe epilepsy, 25 cases of temporal lobe epilepsy 80 cases, the occipital lobe epilepsy patients, parietal lobe epilepsy cases. 2:2.1 forms of attack: 35 cases underwent surgery were monitoring to the 134 clinical onset of the 34 patients, including 38 simple partial seizures, simple partial seizures secondarily generalized seizures 9, complex partial seizures 60 times, complex partial seizures secondarily generalized seizures 27. According to the form of seizures and EEG classification: temporal lobe epilepsy 22 cases, frontal lobe epilepsy eight cases of occipital lobe epilepsy, parietal lobe epilepsy cases. 2:2.2 between attacks of EEG: (1) focal epileptiform wave (sharp waves, spikes, sharp slow wave) 18. The ② unilateral trend paroxysmal irregular slow wave 9 cases; no obvious laterality trend burst of irregular slow waves in 11 cases. ③ paroxysmal head high voltage rhythmic slow-wave cases 5 cases. (4) paroxysmal the focal low voltage brainwave 7 cases. The ⑤ only performance increased background EEG slow wave three cases. Analysis of interictal EEG, 20 cases identified as unilateral discharge, 12 patients had bilateral discharge, three cases no legal side. 2:2.3 ictal EEG: seizure onset of brain electrical performance can be summarized as: 1. Focal isolated sharp waves, spikes or sharp slow wave complex 11 cases (spine). Rhythmic slow wave in 12 cases. Low voltage fast wave rhythm in 15 cases. 4 universality of low-voltage EEG in 8 cases. Attack from the starting position the initial brainwave frequency or amplitude change location and the side do not determine to do for the starting side, the unilateral side clear position (side) of the 24 cases, 14 cases in which the left side, the right side of 10 cases showed bilateral discharge side of the eight cases, can not be determined; the ictal EEG performance: (1) high-voltage spikes, spikes, sharp (spine) slow wave, District 12 cases of focal advantage. (2) high-voltage slow wave-based, the frequency gradually accelerated, but still slow-wave 11 cases. (3) high-voltage fast wave rhythm of 16 cases. Ictal EEG can be positioned (side) of the 13 cases, seven cases of bilateral discharge side in 14 cases, can not be clearly identified. EEG integrated 2:2.4 ictal EEG attack interval positioning (Fixed side): a comprehensive analysis between attacks, seizures start and ictal EEG of VEEG for 31 cases (88.6%) patients caused by the side of the epileptic foci, four cases between attacks and attacks from the period stated or not clear positioning should also be taken into account in the form of attacks and imaging data (show structural lesions) to determine the surgical site. 2:2.5 intraoperative EEG findings: all patients with cortical EEG have epileptiform discharges, mainly for the high-amplitude spikes spikes payment, significantly reduced postoperative tracing remember ECOG epileptic discharge. Conclusion: video-EEG significantly improve epileptiform waves detection rate, and provide an important basis for the diagnosis, differential diagnosis and classification of epilepsy. Video EEG monitoring is an important means of localization in epilepsy surgery, especially EEG seizure onset of epilepsy preoperative caused the essential basis for the localization of epileptic foci.
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