立体定向脑电图在儿童致痫性下丘脑错构瘤中的应用  

Application of stereoelectroencephalogram in children with epileptogenic hypothalamic hamartoma

作　　者：冯韬 卢超[1] 孟飞 王逸鹤[1] 张华强 魏鹏虎 单永治[1] 赵国光[1] Feng Tao;Lu Chao;Meng Fei;Wang Yihe;Zhang Huaqiang;Wei Penghu;Shan Yongzhi;Zhao Guoguang(Department of Neurosurgery,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院神经外科,北京100053

出　　处：《中华临床医师杂志（电子版）》2021年第8期584-590,共7页Chinese Journal of Clinicians(Electronic Edition)

基　　金：国家自然科学基金委重点项目(82030037)。

摘　　要：目的初步探讨立体定向脑电图(SEEG)技术在儿童下丘脑错构瘤所致癫痫治疗中的作用。方法回顾性分析2015年7月至2019年3月首都医科大学宣武医院神经外科收治的17例下丘脑错构瘤继发癫痫患儿的临床资料。所有的患儿均行SEEG检查及SEEG引导下射频热凝治疗。采用Engel分级评估患儿术后的疗效。结果17例患儿共植入62根电极,每例植入1~6根电极,平均(3.6±1.4)根。随访时间为24~68个月,平均(33.9±11.6)个月。术后9例患儿癫痫得到完全控制(EngelⅠ级),5例术后发作部分改善(EngelⅢ级),3例患儿经射频热凝治疗后癫痫无明显改善(EngelⅣ级)。所有病例均未发生永久性神经功能缺损。结论SEEG引导射频热凝毁损术是儿童下丘脑错构瘤继发癫痫安全、有效的治疗方式。Objective To explore the values of stereoelectroencephalogram(SEEG)in the treatment of epilepsy caused by hypothalamic hamartoma in children.Methods The clinical data of 17 children with epilepsy secondary to hypothalamic hamartoma admitted to the Department of Neurosurgery,Xuanwu Hospital,Capital Medical University from July 2015 to March 2019 were retrospectively analyzed.All patients underwent SEEG examination and SEEG-guided radiofrequency thermocoagulation.Engel classification was used to evaluate the postoperative efficacy.Results A total of 62 electrodes were implanted in 17 patients,and 1 to 6 electrodes were implanted in each patient,with an average of(3.9±1.4)electrodes per patient.The postoperative follow-up time was 24 to 68 months,with an average of(33.9±11.6)months.Epilepsy was completely controlled in nine cases(EngelⅠ),partial improvement was achieved in five cases(EngelⅢ),and there was no significant improvement in three cases(EngelⅣ)after radiofrequency thermocoagulation.No permanent neurological deficit was found.Conclusion SEEGguided radiofrequency thermocoagulation is a safe and effective treatment for epilepsy secondary to hypothalamic hamartoma in children.

关 键 词：下丘脑错构瘤 立体定向脑电图 儿童 神经外科手术 射频热凝 

分 类 号：R726.5[医药卫生—儿科]