SEEG高频电刺激在难治性癫疒间手术定位中的应用  

Application of SEEG guided high frequency electrical stimulation in surgical localization of refractory epilepsy

作　　者：付萌萌 陈富勇 吴戊辰 李瑞麒 贾彬滨 尚宝祥 陶蔚 陈勇 孟祥红 Fu Mengmeng;Chen Fuyong;Wu Wuchen;Li Ruiqi;Jia Binbin;Shang Baoxiang;Tao Wei;Chen Yong;Meng Xianghong(Department of Neurosurgery,Epilepsy Center of Shenzhen University General Hospital,Clinical Research Center for Neurological Disorders,Shenzhen University,Shenzhen,Guangdong 518065,China)

机构地区：[1]深圳大学总医院神经外科癫疒间中心深圳大学神经系统疾病临床医学研究中心,518065

出　　处：《中国微侵袭神经外科杂志》2021年第2期62-65,共4页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的探讨立体定向脑电图(stereoelectroencephalography,SEEG)高频电刺激诱发惯常发作与难治性癫疒间手术预后的相关性。方法回顾性分析30例难治性癫疒间病例资料,均行SEEG引导下高频电刺激,电刺激频率50 Hz、脉宽0.3 ms,持续时间5~7 s。高频电刺激所诱发的发作,按照与自然发作的临床表现和SEEG脑电图演化对比,分为典型惯常发作、部分惯常发作、无惯常发作。本组病人均行致疒间灶切除术或SEEG引导下致疒间网络射频热凝术。结果随访时间9~22个月,平均14.7个月。行致疒间灶切除术10例,EngelⅠ级7例,其中5例诱发出典型惯常发作;SEEG引导下致疒间网络射频热凝术20例,EngelⅠ级12例,其中6例诱发出典型惯常发作。高频电刺激诱发惯常发作与手术疗效存在显著相关性(r=0.435,P=0.016)。结论 SEEG高频电刺激诱发惯常发作与手术预后存在显著相关性,安全可行。Objective To explore the relationship between stereoelectroencephalography(SEEG) high-frequency electrical stimulation-induced habitual seizures and the prognosis of refractory epilepsy surgery. Methods The data of 30 patients with refractory epilepsy were analyzed retrospectively. High-frequency electrical stimulation was performed under the guidance of SEEG. Electrical stimulation frequency was 50 Hz, pulse width was 0.3 ms, and stimulation time was 5 to 7 s. The seizures induced by high-frequency electrical stimulation were divided into typical habitual seizures, partial habitual seizures, and no habitual seizures according to the clinical manifestations of natural seizures and the evolution of SEEG. All the patients underwent epileptic foci resection or SEEG-guided epileptic network radiofrequency thermocoagulation. Results The follow-up time was 9-22 months, with an average of 14.7 months. The epileptic foci resection was performed in 10 patients, Engel grade I was in 7, 5 of whom were induced of typical habitual seizures. SEEG guided radiofrequency thermocoagulation for epilepsy was performed in 20 cases, and Engel I was in 12, 6 of whom were induced of typical habitual seizures. The high-frequency electrical stimulationinduced habitual seizures were significantly correlated with surgical efficacy(r = 0.435, P = 0.016). Conclusions SEEG highfrequency electrical stimulation induces habitual seizures, which has a significant correlation with the prognosis of surgery, and is safe and feasible.

关 键 词：癫疒间 难治性 立体定向脑电图 皮质电刺激 高频 

分 类 号：R742.1[医药卫生—神经病学与精神病学]