摘要
目的探讨SEEG引导下射频热凝致痫灶治疗药物难治性癫痫的有效性及安全性。方法选择18例需行SEEG电极植入术行致痫灶切除术前评估的患者,根据颅内脑电监测结果,对可疑致痫灶进行热凝,热凝后继续监测脑电变化,必时可多次热凝。拔出电极后复查头部MRI,观察热凝后影像改变。结果18例患者毁损靶点4~16个,靶点分布于1~6根电极,热凝次数1~3次。随访期1~4个月,热凝后EngelI级患者占44.4%(8/18),EngelIII级患者占5.6%(1/18),EngelIV级50%(9/18),总体有效率(发作减少≥75%)50%(9/18)。热凝后无颅内出血、神经功能受损等并发症。结论SEEG引导下射频热凝是一种安全有效的微创治疗癫痫方法,值得临床推广和应用。
Objective To investigate the effectiveness and salty of using SEEG(stereoelec- troencephalography) guided radiofrequeney thermocoagulation as a method in the treatment of in- tractable epilepsy. Methods We chose 18 patients who need SEEG electrodes implantation to de- lineate the best region for epileptogenic zone resection. SEEG guided radiofrequeney--thermo- coagulation of the epileptic foci were performed according to the SEEG recording. The electrodes still retain in situ and SEEG recording kept on after coagulation. MRI was performed after the re- moval of the electrodes in order to observe changes of the target tissues. Results At a follow--up time of 1-4 months,44.4% of the patients achieved Engel class I,5.6% of patients achieved En- gel class III ,50% of patients showed no benefit. The total improvement was 50% of the patients. No permanent neurologic impairment occurred or intraeranial hemorrhage after any of the pa- tients. Conclusion SEEG guided radiofrequency thermocoagulation of the epileptogenic zone is safe and effective in the treatment of intractable epilepsy, and some patient may achieve seizure free after that treatment.
作者
柏建军
林久銮
王海祥
张冰清
宋宪成
李佳
阮静
胡京霞
周文静
Bai Jianjun Linjiuluan Wang Haixiang et al(Department of Neurosurgery , Tsinghua University Yuquan Hospital ,Beijing , 100049 ,China.)
出处
《立体定向和功能性神经外科杂志》
2016年第5期257-261,共5页
Chinese Journal of Stereotactic and Functional Neurosurgery
关键词
癫痫
SEEG
射频热凝
Epilepsy
SEEG
Radiofrequency thermocoagulation