基于立体脑电图的岛叶功能分析

The analysis of insula lobe function based on the Stereo-electroencephalography

目的 了解岛叶的功能,研究总结其解剖与功能的相关性,为癫痫的定位诊断提供依据.方法 对2013年12月-2015年9月在上海交通大学附属仁济医院功能神经科住院的部分药物难治性癫痫患者12例置入了立体脑电图(SEEG),颅内的电极选择在岛叶上的触点,通过电刺激观察临床表现,还原至解剖图上做脑功能图谱,研究岛叶的功能与解剖之间的关系.结果 12例药物难治性癫痫患者,位于岛叶上的触点为176个,排除后放电触点22个,共154个触点.主要临床表现为躯体感觉异常、喉部不适、呼吸改变、恶心、心慌等,其中躯体感觉症状位于岛叶中后部,内脏感觉症状相对靠前,其余症状主要分布于岛叶前、中部.结论 岛叶功能据其解剖的分布有一定的规律,但存在部分交叉,且症状相对复杂,同一部位在不同个体的表现不尽一致.

Objective To understand the relationship between the anatomy and the function of the insula lobe cortex based on the stereo-electro encephalography(SEEG)by direct electric stimulaion of the insula cortex performed in the patients who suffered from the refractory epilepsy.Methods Retrospective review was performed on 12 individuals with refractory epilepsy who were diagnosed in the Department of Functional neurosurgery of RenJi Hospital from December 2013 to September 2015.We studied all the SEEG electrodes implanted in the brain with contacts in the insula cortex.Direct eletic stimulation was given to gain the brain mapping of the insula.Results 12 consecutive patients with refractory epilepsy were implanted SEEC electrodes into the insula cortex.In all,176 contacts were in the insula cortex,and 154 were included.The main clinical manifestations obtained by the stimulation were sonatosensory abnormalities,laryngeal constriction,dyspnea,nausca,flustered.While somatosensory symptoms were located in the posterior insula,visceral sensory symptoms distribute relatively in the anterior insula,and other symptoms were mainly in the central and anterior part.Conelusions The symptoms of the insula present mainly according to the anatomy,but some of them are mixed.In addition,the manifestations of the insula are usually complex and indiviually.