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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,必要时可多次热凝。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Engel Ⅰ级患者占44.4%(8/18),Engel Ⅲ级患者占5.6%(1/18),Engel Ⅳ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 efficacy and safety of SEEG-guided radiofrequency thermocoagulation in the treatment of refractory epilepsy. Methods Eighteen patients undergoing SEEG electrode implantation for preeclamptic resection were enrolled. According to the results of intracranial EEG monitoring, the suspicious epileptogenic zone was subjected to thermal coagulation and thermocoagulation to monitor the changes of EEG. If necessary, Can be multiple thermal coagulation. After pulling out the electrode, review the head MRI and observe the image change after the pyrolysis. Results Eighteen patients had 4-16 target sites for destruction, and the targets were located on 1-6 electrodes with the number of thermal coagulation being 1 ~ 3 times. During the follow-up period of 1 ~ 4 months, Engel Ⅰ grade patients accounted for 44.4% (8/18), Engel Ⅲ grade patients (1/18) and Engel Ⅳ grade patients (9/18) Efficiency (onset reduced ≥75%) 50% (9/18). No coagulation after intracranial hemorrhage, nerve damage and other complications. Conclusion SEEG-guided radiofrequency thermocoagulation is a safe and effective method of minimally invasive treatment of epilepsy, which is worthy of clinical promotion and application.