热凝毁损杏仁核对痫性放电的抑制作用

The inhibitory effect of thermal coagulating amygdalotomy to EEG epileptic discharge

目的 探讨热凝毁损杏仁核对头皮痫性放电的抑制作用。方法 对本院2005年1月～2006年5月收治的58例癫痫患者常规进行24小时视频脑电监测、偶极子分析，对有痫性放电的患者机器人辅助立体定向引导深部电极植入杏仁核，记录其电活动，其后热凝毁损杏仁核，复查深部电极和头皮脑电。结果 58例癫痫患者全部记录到头皮棘尖波，56例（96．55％）存在杏仁核痫性放电。热凝毁损杏仁核后，其痫性放电消失42例，明显减少14例，无无效者，复查头皮脑电棘尖波消失20例，明显减少32例，无明显差别者6例。结论 热凝毁损杏仁核可明显抑制包括颞叶内侧放电的半球痫性放电。

Objective To assess inhibitory effect of thermal coagulating amygdalotomy to EEG epileptic discharge. Methods From Jan 2005 to May 2006 in Neurosurgery Department of the Navy General Hospital, 58 patients with epilepsy were studied with long time video EEG and dipole analysis. If the patient had epileptic discharge in long time video EEG, a depth electrode was placed to amygodaloid nuclear with computer and robot assisted stereotactic apparatus. If there was epileptic discharge, the patient accepted amygdalotomy by thermal coagulation system. After accepted with thermal coagulation, the patient was checked by depthelectrode and routine EEG. Results The 58 epilepsy patients all had EEG spike-sharp waves and 56 （96. 55%）epilepsy patients had epileptic discharge in amygodaloid nuclears. These 56 patients who had epileptic discharge after operation of thermal coagulation, there were 42 patients whose epileptic discharges were disappear, 14 patients were obviously reduced. When the 58 patients checked EEG, there were 20 patients whose spike-sharp waves were disappear, 32 patients were obviously reduced, 6 patients was not changed. Conclusion Amygdalotomy by thermal coagulation system could mostly reduced epileptic discharge from cerebrum, including epileptic discharge from medial temporal.