关键词: 大脑半球软化灶, 大脑半球切除术, 脑电图

Abstract: Objective To study the significance of electroencephalogram (EEG) before and after hemispherectomy and preoperative localization.Methods To summarize the clinical data of 12 patients who underwent cerebral hemispherectomy from April 2016 to April 2020 in the Epilepsy Center of Beijing Aviation General Hospital,and to analyze and summarize the characteristics of electroencephalogram (EEG) during the interictal period before surgery,during the interictal period and six months after surgery.Results Cranial magnetic resonance imaging (MRI) examination of 12 patients showed softening foci in one hemisphere and normal contralateral hemisphere.EEG background activity showed continuous asymmetry in both hemispheres,the EEG amplitude of the lesion side was significantly lower than that of the opposite side,intermittent discharge:bilateral brain discharge was detected in 5 patients,and the discharge sites of the other 7 patients were consistent with the lesion side.EEG in attack stage:the origin of attack was in the opposite side of the lesion in 1 patient,the origin of seizure was detected in 2 patients,and the origin of epileptic discharge in the remaining 9 patients was consistent with that in the lesion side.All patients received hemispherectomy or amputation on the side of the lesion.Postoperative follow-up was conducted to evaluate the surgical efficacy,electroencephalogram discharge and surgical complications.Twelve patients did not have seizures,and all patients were examined by electroencephalogram 6 months after surgery.Epileptic discharge disappeared in the contralateral interictal phase in 4 patients,and decreased slightly in the contralateral side in 1 case.The remaining 9 patients had slow wave discharge on the resection side and normal contralateral side.The EEG of 12 patients was basically normal one year after operation.Conclusion EEG has certain value for preoperative location diagnosis and prognosis evaluation of patients with cerebral softening lesions.When analyzing EEG of patients with cerebral softening lesions,imaging characteristics of patients should be fully analyzed.When the origin of EEG is in the same side with the softening lesions,hemispherectomy on the affected side can achieve better results.When bilateral abnormal discharge occurs,the possibility of good prognosis can not be ruled out,and hemispherectomy can be considered.When it is clear that the softened side is no longer functional,surgical resection is the best treatment.

Key words: Cerebral hemispheromalacia, Hemispherectomy, Electroencephalogram