CAJ | 학술논문

目的探讨脑深部电极脑电图在脑深部局灶性灰质异位相关癫痫的应用价值.方法同顾性分析应用脑深部电极脑电图进行定位的4例灰质异位症和1例下丘脑错构瘤病例的资料.结果男3例,女2例,年龄18～28岁,异位灰质分别位于左额2例、下丘脑、左顶和右枕各1例,病程5-27年.4例癫痫发作表现全面性发作,同时3例发作期脑电图表现为双侧广泛痫性放电.5例均行立体定向病灶内深部电极埋藏术,4例同时埋藏皮层电极,确定癫痫灶均为异位灰质结构,3例行病灶立体定向病灶毁损术,靶点为2～4个,温度为70℃,时间为80 s,2例行立体定向引导下直接手术切除病灶.随访时间12-23个月,下丘脑错构瘤患者癫痫发作减少80%,其他4例目前随访均无发作.无并发症出现.结论深部电极埋藏脑电图是定位脑深部局灶性灰质异位相关癫痫致痫病灶的重要方法,局灶性病灶可能出现全面性癫痫发作和广泛性脑电图异常.
목적 탐토뇌심부전겁뇌전도재뇌심부국조성회질이위상관전간적응용개치.방법 동고성분석응용뇌심부전겁뇌전도진행정위적4례회질이위증화1례하구뇌착구류병례적자료.결과 남3례,녀2례,년령18～28세,이위회질분별위우좌액2례、하구뇌、좌정화우침각1례,병정5-27년.4례전간발작표현전면성발작,동시3례발작기뇌전도표현위쌍측엄범간성방전.5례균행입체정향병조내심부전겁매장술,4례동시매장피층전겁,학정전간조균위이위회질결구,3례행병조입체정향병조훼손술,파점위2～4개,온도위70℃,시간위80 s,2례행입체정향인도하직접수술절제병조.수방시간12-23개월,하구뇌착구류환자전간발작감소80%,기타4례목전수방균무발작.무병발증출현.결론 심부전겁매장뇌전도시정위뇌심부국조성회질이위상관전간치간병조적중요방법,국조성병조가능출현전면성전간발작화엄범성뇌전도이상.
Objective Heterotopia gray matter (HGM) and hypothalamic hamartoma (HH ),congenital brain malformation underlied by neuronal migration disorders,are one of significant causes of epilepsy,this paper is to discuss the value of deep brain needle electrode EEG in epileptogenic zone localization in patients with nodule HGM and HH.Methods Intracranial electrodes EEG data of patient with HGM and HH was analyzed retrospectively.Methods This cohort included 5 cases (2 females and 3males) whose ages at surgery were from 18 to 28 year old.The heterotopic grey lied in left frontal lobe in 2patients,and hypothalamus,left parietal lobe and right occipital lobe in 1 case respectively.Generalized seizure attack was found in 4 cases and generalized ictal discharge in scalp EEG were presented in 3 patients.All patients underwent intracranial electrode EEG recording,and 1 case used needle electrode as exclusive intracranial electrode.3 patients were performed stereotactic lesion radiofrequency ablation with 2 -4 targets for 80 s with 70℃,and others were used lesion remove under stereotactic guiding.During 12-23 months follow up,4 patients with HGM rendered seizure free,and the patient with HH presented 80% seizure reduction without complication.Conclusion Deep brain needle electrode EEG is an important tool to epileptogenic zone localization of patients with brain heteotopic grey,and focal lesion could present generalized seizure attack and epileptiform discharge.