颅内电极置入与脑功能区定位技术在功能区难治性癫疒间手术的应用  

Application of insertion of intracranial electrode and localization of the eloquent area in surgery for intractable epilepsy

作　　者：卢明巍[1] 洪涛[1] 陈立科[1] 况建国[1] 

机构地区：[1]南昌大学第一附属医院神经外科,330006

出　　处：《中国微侵袭神经外科杂志》2013年第6期247-249,共3页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的探讨颅内电极埋藏与脑功能区定位技术在功能区起始的难治性癫疒间手术的评估价值。方法回顾性分析7例难治性癫疒间的临床资料,头皮视频脑电图长程监测均考虑致疒间灶可能累及功能区,故行颅内电极置入术,再行皮质电极视频脑电图长程监测,记录发作间期和发作期脑电图,以判断致疒间皮质,并采用皮质电刺激行脑功能区定位,在指导术中尽可能切除致疒间皮质的同时,最大限度保护脑功能。结果癫疒间发作起始区切除2例,癫疒间起始区部分切除加周围皮质热灼5例。随访6个月~1年,术后运动及语言功能均保护良好6例,对侧肢体出现短暂运动障碍后恢复1例。结论颅内电极埋藏与脑功能区定位技术是功能区难治性癫疒间手术必要评估手段,有助于术前明确脑功能区和皮质放电区域,以及两者之间的关系,指导设计手术方式,最大限度提高病人术后生活质量。Objective To explore the value of insertion of intracranial electrode and brain functional region mapping in pre-operation evaluation of intractable epilepsy in the brain functional region.Methods The data of 7 intractable epilepsy cases were analyzed retrospectively.Because the long-term video electroencephalography（EEG） showed the epileptogenic zone often involved the cerebral function area,insertion of intracranial electrode was performed for recording ictal and inter-ictal EEG,making the epileptogenic zone clear,and mapping the brain functional region.It can not only resect more epileptogenic zone,but also maintain more important brain function.Results The epileptogenic zone was resected in 2 cases,and partial resection of the epileptogenic zone and thermal coagulation of the surrounding cortex was done in 5 cases.Follow-up of 6 months to 1 year found that the motor and language was as good as pre-operation in 6 cases,and short-time motor disturbance and then recovered in 1.Conclusions The insertion of intracranial electrode and brain functional area mapping is a assessment approach necessary for surgery for intractable epilepsy in the cerebral function area.They are helpful to make the relationship of the epileptogenic zone and the cerebral function area clear,also can guide the development of surgical planning,and improve the quality-of-life of the patient to the greatest degree.

关 键 词：癫疒间 颅内电极 皮质电刺激 立体定位技术 功能区 

分 类 号：R742.1[医药卫生—神经病学与精神病学]