立体定向海马深部电极置入在颞叶癫痫外科中的应用  

Stereotactic hippocampal deep electrodes implanted in the application of temporal lobe epilepsy surgery

作　　者：施建[1,2] 魏祥品 刘向 范振 钱若兵 牛朝诗 汪业汉 

机构地区：[1]安徽医科大学附属省立医院神经外科 [2]脑功能与脑疾病安徽省重点实验室,合肥230001

出　　处：《立体定向和功能性神经外科杂志》2014年第6期336-340,共5页Chinese Journal of Stereotactic and Functional Neurosurgery

基　　金：安徽省卫生厅医学科研课题项目(编号:13zc036);安徽省重点实验室绩效考核补助项目(编号:1306c083028)

摘　　要：目的探讨应用立体定向技术双侧海马置入深部电极脑电监测对颞叶癫痫的定侧定位价值。方法对15例无创影像及脑电检查难以定侧定位的颞叶癫痫患者,在MR定位引导下行立体定向双侧海马深部电极置入,视频脑电监测描记发作期及发作间期脑电图,根据监测结果对癫痫灶进行定侧定位,行个体化癫痫外科手术治疗,术后正规口服抗癫痫药物并随访。结果术后随访最长44个月,最短8个月,平均21个月。疗效满意8例(54%),显著改善5例(33%),良好2例(13%)。术后1例出现视野缺损,无其他严重并发症。结论立体定向双侧海马深部电极置入及脑电监测,微创、安全、准确,是难治性颞叶癫痫定侧定位的可靠的方法,对制定个体化手术方案具有决定性作用。Objective To discuss the value of stereotactie implanting hippocampal depth EEGs monitoring to localize the epileptogenic zone in temporal lobe epilepsy.Methods The depth electrodes were implanted in hippocampus in the guidance of MR and stereotactic in 15 patients with temporal lobe epilepsy,whose epileptogenic zone were difficulty to be localized or lateralized.Using video eeg monitoring to trace stage attacks and attacks between electroencephalogram.Epileptogenic zones were determined according to the monitoring results,and adopted individualized epilepsy surgery,regular oral antiepileptic drugs and follow-up after surgery.Results The longest postoperatie obseration period was 44 months,the shortest 8months,an average of21 months.The following-up outcomes showed that the satisfaction were 8cases（54%）,significant improvements were 5cases（33%）,good was two cases（13%）.There were no serious complications.Only one patient postoperative appeared with visual field defect.Conclusion To record hippocampal EEG in patients with intractable epilepsy by stereotactic implanting depth elcctrode into the hippocampus is a minimally invasive,safe and accurate method to localize lateralize epileptogenic zones in patients with temporal lobe epilepsy.It has a decisive role in formulate individualized operation scheme.

关 键 词：颞叶癫痫 立体定向技术 脑电描记术 深部电极 海马 

分 类 号：R742.1[医药卫生—神经病学与精神病学]