多技术融合在12例功能区癫痫手术中应用  

Application of multiple technology fusion in epilepsy involved functional area

作　　者：侯智[1] 李维[1] 安宁[1] 石先俊[1] 刘仕勇[1] 

机构地区：[1]第三军医大学新桥医院神经外科,全军癫痫诊治中心,重庆400037

出　　处：《立体定向和功能性神经外科杂志》2015年第2期77-79,共3页Chinese Journal of Stereotactic and Functional Neurosurgery

摘　　要：目的探讨多种技术融合在功能区癫痫中的应用价值。方法回顾性分析在12例功能区癫痫中使用颅内电极埋藏的患者临床资料,其中栅格状10例,立体深部结合条状2例,进行视频脑电图检测,记录发作期及间歇期脑电图变化,确定癫痫病灶,并给予皮层电刺激定位功能区部位。结果 12例患者均记录到临床惯常发作,均行电刺激定位功能区部位。术中结合影像导航融合技术,行局部脑回切除10例,2例行多软膜下横纤维切断术。术后Engle评分,I级8例,II级3例,III级1例。所有病例均未出现明显的埋藏电极引起的并发症。结论在功能区癫痫的患者中,使用颅内电极埋藏能更准确的定位癫痫病灶,切除痫灶能有效控制癫痫发作,提高癫痫的治愈率,有效的减少了对功能区损伤。Objective To study the application of multiple technology fusion in surgical resection of epileptic lesions in functional area.Methods The clinical data of 12 patients with epilepsy involved functional area and used intracranial buried electrode were retrospectively analyzed.Grid electrodes were implanted in 10 cases,and depth electrodes were implanted in the other 2.Epileptogenic zones were confirmed by video electroencephalogram（V-EEG）recording the ictal and interictal EEGs.And functional areas were confirmed by cortical electrical stimulation.Results Usual attacks were recorded in all the 12 patients,and all patients got electrical stimulation to indentify the functional area.Finally,with the help of imaging navigation,10 patients got focal cortex resection,and 2got multiple subpial transection（MST）.After surgery,8patients became completely seizure-free（Engle Class I）,3almost seizure-free（Engle Class II）,and additional one had significant seizure control（Engle Class III）.No obvious complication was caused by intracranial buried electrode in all cases.Conclusion Intracranial buried electrode can help locating the epileptogenic zone and functional area accurately.And accurate epileptogenic zone resection can help controlling seizures,increasing the cure rate,and reducing function damage.

关 键 词：功能区癫痫 颅内电极 皮层电刺激 定位 

分 类 号：R742.1[医药卫生—神经病学与精神病学]