高频脑磁分析在立体定向脑电图射频热凝治疗药物难治性癫痫中的应用  

Application of high-frequency magnetoencephalography in stereo-electroencephalography radiofrequency thermocoagulation therapy for drug-refractory epilepsy

作　　者：付东翔 吴杰 谭家亮 谷宇 陈月明 陆东生 FU Dongxiang;WU Jie;TAN Jialiang;GU Yu;CHEN Yueming;LU Dongsheng(Department of Neurosurgery,Guangdong Sanjiu Brain Hospital,Guangzhou 510080,China)

机构地区：[1]广东三九脑科医院神经外科,广州510080

出　　处：《临床神经外科杂志》2024年第6期624-628,共5页Journal of Clinical Neurosurgery

基　　金：广东省医学科学技术研究基金项目(B2022014)。

摘　　要：目的 探讨高频脑磁分析在立体定向脑电图(SEEG)射频热凝治疗药物难治性癫痫中的应用和疗效分析。方法 回顾性分析广东三九脑科医院神经外科六病区2022年1月-2022年12月收治的11例药物难治性癫痫患者的临床资料。应用CURRY8软件将患者的多种影像学及电生理数据进行融合分析评估,定位可能的致痫灶,根据评估结果制定SEEG电极植入计划,并行脑深部电极植入。术后行SEEG监测观察患者发作期脑电改变,结合术前影像及SEEG数据,根据分析结果行脑深部电极癫痫灶毁损术,术后定期随访3~6个月,评估手术疗效。结果 11例患者根据SEEG观察到的发作起始位点,行脑深部电极毁损术。术后随访6例患者疗效达EngelⅠ级,3例为Ⅱ级,1例为Ⅲ级,1例为Ⅳ级。结论 高频脑磁分析方法安全可靠,可以为致痫灶的定位提供更精确的依据,结合多种影像学及电生理进行的多模态融合分析评估,可以更加直观、更加精准地定位癫痫灶,并且优化SEEG植入计划,能以最小的创伤获得手术最大的疗效,为药物难治性癫痫患者带来更大收益。Objective To explore the application and efficacy of high-frequency brain magnetic field analysis in stereo-electroencephalography(SEEG)radiofrequency thermal coagulation treatment for drug-resistant epilepsy.Methods The data of 11 patients with drug-resistant epilepsy who were admitted to the sixth ward,Department of Neurosurgery,Sanjiu Brain Hospital of Guangdong Province,from January 2022 to December 2022 were analyzed retrospectively.CURRY8 software was utilized for fusion analysis and evaluation of various imaging and electrophysiological data to locate possible epileptogenic foci and develop a plan for SEEG electrode implantation and parallel deep brain electrode implantation was performed.Postoperative SEEG was performed to monitor and observe the patients EEG changes during the seizure period,combined with the preoperative images and SEEG data.Deep brain electrode epileptic foci destruction was performed according to the analyzed results,and the surgical efficacy was evaluated by regular postoperative follow-up for 3-6 months.Results Eleven patients underwent deep brain electrode radiofrequency thermocoagulation disruption based on the seizure initiation sites observed by SEEG.The efficacy of postoperative follow-up was Engel gradeⅠin 6 patients,gradeⅡin 3,gradeⅢin 1,and gradeⅣin 1.Conclusions High-frequency magnetoencephalography analysis is both safe and reliable,providing a more precise foundation for the localization of epileptogenic zones.When combined with multimodal fusion analysis and comprehensive evaluation of various imaging techniques and electrophysiology,it enables a more intuitive and accurate identification of epileptogenic zones while optimizing the SEEG implantation plan.This approach ensures maximum surgical efficacy with minimal trauma,thereby offering significant benefits to patients suffering from drug-resistant epilepsy.

关 键 词：高频脑磁 药物难治性癫痫 立体定向脑电图 射频热凝毁损 

分 类 号：R742.1[医药卫生—神经病学与精神病学]