临床神经外科杂志2023，Vol.20Issue(6)：614-618,5.DOI:10.3969/j.issn.1672-7770.2023.06.003
立体脑电图在198例颞岛叶癫痫术前评估中的应用
Application of stereoelectroencephalography in preoperative evaluation of 198 temporal insula epilepsy:single center experience
摘要
Abstract
Objective:To explore the safety and effectiveness of stereoelectroencephalogram(SEEG)in the diagnosis and treatment of drug refractory epilepsy in temporal and insular lobes.Methods The clinical data of patients who underwent SEEG electrode implantation at the Epilepsy Center of Guangdong Sanjiu Brain Hospital from September 2014 to December 2020 were analyzed retrospectively.All patients underwent a detailed preoperative non-invasive assessment(including recording of scalp electroencephalogram,brain magnetic resonance imaging,intermittent positron emission tomography-computer tomography,neuropsychological assessment,etc.),and ROSA robot was used to insert intracranial electrodes to monitor the interictal and electroencephalograms,record habitual seizures,and determine the origin of the epileptic focus and the location of the functional area based on the results of the intracranial electrode electroencephalogram during the attack before surgical resection.Results A total of 564 patients underwent SEEG electrode implantation,including 414 adults and 150 children.The total number of electrodes was 6 190,including 198 patients with temporal and insular lobe SEEG electrodes implantation,with a total of 2 147 electrodes.The temporal and insular lobe electrodes implantation patients had a minimum age of 8 years and a maximum age of 52 years,with an average age of(20.2±8.5)years.There were 138 males(69.7％)and 60 females(30.3％),with an average of(10.8±0.7)roots per case.141 cases(71.2％)were implanted unilaterally and 57 cases(28.8％)were implanted bilaterally,of which 2 cases were supplemented with electrodes(7 in total).Intracerebral hematoma occurred in 3 patients,emergency operation was performed in 2 patients,a small amount of subarachnoid hemorrhage occurred in 4 patients without obvious clinical symptoms,and one electrode was broken in 2 patients during seizure.No death,infection or cerebrospinal fluid leakage occurred.The maximum error of electrode was 5.2 mm,the minimum error was 0,and the average error was 2.1nm.196 patients with temporal and insular lobe epilepsy underwent surgical resection and 2 cases were not operated.The postoperative follow-up time was 6-75 months.152 patients(78.7％)had Engel Class Ⅰ,27(14％)had Engel Class Ⅱ,9(4.7％)patients had Engel Class Ⅲ,5(2.6％)patients had Engel Class Ⅳ,3 patients were lost in follow-up.Conclusions SEEG is an effective and relatively safe minimally invasive procedure.It has important diagnostic and therapeutic value for intractable mesial temporal and insular lobe epilepsy which involving rich blood vessels and deep structures.Proficiently mastering the implantation technology can reduce the incidence of postoperative complications.关键词
ROSA机器人/药物难治性癫痫/立体脑电图/颞叶癫痫/岛叶癫痫Key words
ROSA robot/drug-refractory epilepsy/stereoelectroencephalogram/temporal lobe epilepsy/insular lobe epilepsy分类
医药卫生引用本文复制引用
陈俊喜,王艮波,周修明,华刚,陈淼彬,唐晓伟,李恺煇,费凌霞,朱丹..立体脑电图在198例颞岛叶癫痫术前评估中的应用[J].临床神经外科杂志,2023,20(6):614-618,5.基金项目
广东省医学科学技术研究基金项目(A2023055) （A2023055）
