颞叶内侧型癫痫海马杏仁复合体发作间期的痫性放电特征与范围

Characteristics and range of interictal amygdalo-hippocampus epileptic discharges in medial temporal lobe epilepsy

目的探索颞叶内侧型癫痫海马杏仁复合体区发作间期痫性放电的特征与范围,为立体定向射频毁损提供可靠依据。方法 235例经多导长程视频脑电加偶极子定位检查提示为颞叶内侧型癫痫患者,经机器人辅助定位在海马杏仁复合体区植入深部电极,监测并分析其放电特征与范围,根据监测结果实施射频毁损术。结果 235例患者均检测到发作间期的痫性放电,共6种形式;痫性放电中心部位波动于靶点下20 mm至靶点上10mm。平均位于靶下6.3507±5.0325 mm。放电范围在垂直于颞叶长轴方向为5－35 mm,平均14.2639±5.1011mm。颅底与放电中心的距离波动于2－25 mm,平均为9.0097±2.9232 mm。结论颞叶内侧型癫痫的痫性放电部位与传统定位的靶点有一定差异,且放电范围各不相同,应以深部电极监测结果实施毁损。

Objective Exploring the Characteristics and range of interictal amygdalo-hippocampus epileptic discharges in medial temporal lobe epilepsy,to provide a reliable evidence for stereotactic radio frequency coagulations.Methods 235 medial temporal lobe epilepsy patients confirmed by long-term video EEG and dipole positioning were implanted deep electrode in amygdalo-hippocampus area with robot assistant system.The characteristics and range of epileptic were analyzed and radio frequency coagulations were made according to the monitoring results Results 6 types of epileptic discharges were found in all 235 patients.The center of the epileptic discharge was ranged in 20 mm below and 10mm above the target（mean 6.3507±5.0325 mm blow the target）.The ranges of discharges were 5 - 35 mm vertical to the long axis of temporal lobe（an average of 14.2639±5.1011 mm）.The distances between the center of discharge and the skull base were 2 - 25 mm（an average of 9.0097±2.9232 mm）.Conclusion The position of epileptic discharge in medial temporal lobe epilepsy is not the same with traditional target and the ranges are quite different.The coagulation should be performed according to the results of deep sited electrode monitoring.