Abstract: Objective  To evaluate the diagnostic value of magnetoencephalography (MEG) in localizing the seizure focus and in predicting outcome to surgical resections of insular lobe epilepsy.  Methods  Eight patients who had been diagnosed as refractory insular lobe epilepsy in Xuanwu Hospital were selected. All patients had pre-surgical work-ups, including MRI, video EEG (VEEG) and MEG to localize epileptogenic area, and 4 of them had been implanted intracranial electrodes to identify epileptogenic zone and underwent operation under the monitoring of electrocorticography (ECoG). They were followed up after surgery to evaluate the prognosis, and further to evaluate the diagnostic value of MEG on insular lobe epilepsy.  Results  Eight patients had surgeries under the guide of preoperative MEG examination. Five of them had been localized in insular or anterior insular lobe and 3 of them had been localized around the insular lesion by MEG. According to postoperative Engel  classification, 6 was Ⅰ, one was Ⅱ, and one was Ⅳ.  Conclusions  MEG provides useful localizing information and predicts surgical outcome of insular lobe epilepsy.

Key words: Epilepsy, Magnetoencephalography, Electroencephalography, Magnetic resonance imaging

摘要： 目的 评价脑磁图对岛叶癫痫的诊断价值。方法 共8 例岛叶癫痫患者术前采用MRI、视频脑电图和脑磁图等项技术综合评价致灶性质并定位，部分患者植入颅内电极并记录皮质脑电图，均手术切除致灶。术后随访评价预后，进一步分析脑磁图对岛叶癫痫的诊断价值。结果 8 例患者术前脑磁图检查对手术切除部位均有指导意义，5 例定位于岛叶和岛叶前部、3 例定位于岛叶病灶周围皮质；术后Engel分级6 例为Ⅰ级、1 例为Ⅱ级、1 例为Ⅳ级。结论 脑磁图对岛叶癫痫的诊断具有一定价值，应综合评价以准确定位致灶。

关键词: 癫痫, 脑磁图描记术, 脑电描记术, 磁共振成像