SEEG引导下RF-TC治疗脑室旁灰质移位症所致药物难治性癫痫(附2例报道并文献复习)  

Clinical efficacy of stereotactic electroencephalogram guided radiofrequency thermocoagulation for refractory epilepsy caused by periventricular gray matter heterotopia:report of 2 case and literature review

作　　者：丁慧超 管江衡 谢天浩 李洋 向露 吕丽辉 刘琴 宋健 徐国政 DING Hui-chao;GUAN Jiang-heng;XIE Tian-hao;LI Yang;XIANG Lu;LV Li-hui;LIU Qin;SONG Jiang;XU Guo-zheng(Department of Neurosurgery,General Hospital of Central Theater Command,Wuhan 430070,China)

机构地区：[1]中部战区总医院神经外科,武汉430070

出　　处：《中国临床神经外科杂志》2023年第7期421-424,共4页Chinese Journal of Clinical Neurosurgery

摘　　要：目的 探讨立体定向脑电图(SEEG)引导下射频热凝毁损术(RF-TC)治疗脑室旁灰质移位症(GMH)所致药物难治性癫痫的疗效。方法 回顾性分析2例脑室旁GMH所致药物难治性癫痫的临床资料,并结合相关文献进行分析。结果 术前根据临床表现、影像学特表现以及脑电图诊断为脑室旁GMH所致药物难治性癫痫,行机器人辅助SEEG记录精确定位致痫区及传导途径,并在SEEG引导下行RF-TC治疗。所有电极偏差在3 mm误差范围以内,术后未发生手术相关并发症,无神经系统相关并发症。术后随访1年,1例癫痫完全控制,1例癫痫发作频率减少80%。结论 脑室旁GMH是导致药物难治性癫痫的原因之一,SEEG引导下RF-TC治疗的效果良好,是一种安全的、有效的治疗方式。Objective To explore the clinical efficacy of stereotactic electroencephalography(SEEG)guided radiofrequency thermocoagulation(RF-TC)for patients with refractory epilepsy caused by periventricular gray matter heterotopia(PGMH).Methods A retrospective analysis was performed on the clinical data of two patients with refractory epilepsy caused by PGMH who underwent SEEG guided RF-TC in our department,and the relevant literatures were reviewed.Results Before the surgery,both patients were diagnosed with refractory epilepsy caused by PGMH according to the clinical features,imaging characteristics and video EEG.Robot-assisted SEEG recording was performed to accurately locate the epileptogenic foci and conduction pathways,and RF-TC under SEEG guidance were performed on both patients.All the electrode deviations did not exceed the error range of 3 mm,and there were no operation related complications or neurological complications.After 1 year of follow-up,the epilepsy of 1 patient was completely controlled,and the seizure frequency was reduced by 80%in the other patient.Conclusions PGMH is one of the causes of drug-resistant epilepsy.SEEG-guided RF-TC is a safe and effective treatment for patients with refractory epilepsy caused by PGMH.

关 键 词：药物难治性癫痫 脑室旁灰质移位症 立体定向脑电图 射频热凝毁损术 疗效 

分 类 号：R742.1[医药卫生—神经病学与精神病学] R651.11[医药卫生—临床医学]