颅内电极埋藏在Lennox-Gastaut综合症中的应用(附10例临床分析)

The application of intracranial electrode buried in the lennox-gastaut syndrome(10cases clinical analysis)

目的探讨颅内电极埋藏术后进行视频脑电图评估在癫痫外科手术致痫灶定位困难的Lennox-Gastaut综合症中的使用。方法收集10例Lennox-Gastaut综合症致痫灶定位困难的患者,向颅内硬膜下植入条状电极,术后进行视频脑电图评估,记录发作间歇期及发作期脑电图变化,确定癫痫病灶的起始区,通过手术方式切除致痫灶。结果本组10例患者埋藏时间为2～7天,平均4天,均记录到间歇期及发作期脑电图情况。根据脑电图结果,行脑叶切除及胼胝体切开。术后按照Engel评分I级4例,II级2例,III级2例,IV级2例。所有病例均未出现埋藏电极引起的严重并发症。结论在致痫灶定位困难的Lennox-Gastaut综合症中,采用颅内电极埋藏进行视频脑电图检测,可以较准确定位主要致痫灶,从而提高Lennox-Gastaut综合症外科治疗有效率。

Objective To investigate the role of chronic intracranial EEG recording in patients with occipital lobe epilepsy for localizing epileptogenic zone. Methods Nine intractable occipital lobe epilepsy patients underwent intracranial chronic EEG monitoring by using subdural grid and strip electrodes. Results The intracranial electrode recording detected epileptogenic zone within 3-9days following electrode implantation. Interictal epileptic discharges were recorded in all patients. Ictal EEG was obtained from predicated location of epileptogenic zone in 9 cases. The surgical outcomes were evaluated according to the Engel Class, Engel Ⅰ in 7 patients, Engel Ⅱ in 2 patients. For all patients no significant complications were found. Conclusion Implantation of intracranial electrodes in selected patients is safe and effective for precise epileptogenic zone localization. Chronic intracranial EEG monitoring is a sensitive approach to localize epileptogenic zone.