颅内电极监测结合神经导航在功能区难治性癫痫手术中的应用

Application of combined intracranial electrode monitoring and neuronavigation in intractable epilepsy surgery of functional areas

  • 摘要: 目的 探讨颅内电极监测结合神经导航技术在难治性癫痫手术中的应用效果。方法 对16例难治性癫痫患者行颅内电极置入术,进行皮层及深部脑电图监测(intracranial EEG,iEEG),对致痫区进行定位,二次手术前行MRI扫描,影像资料传输至计算机工作站,明确致痫灶与功能区皮层的解剖关系及功能联系,行神经导航下及iEEG精准定位的显微手术,最大限度地切除致痫灶同时最大程度的避免功能区损伤。结果 术后随访2-26个月:EngelⅠ级13例,Ⅱ级2例,Ⅲ级1例。无术后神经功能障碍。结论 颅内电极监测结合神经导航的应用可使难治性癫痫外科手术更精确,侵袭更小。

     

    Abstract: Objective To study the application of combined intracranial electrode monitoring and neuronavigation in intractable epilepsy surgery. Methods Intracranial electrodes were implanted into 16 patients with refractory epilepsy.Epileptogenic zone in the patients was located on intracranial EEG(iEEG).Magnetic resonance scanning was performed before the second operation.Imaging data were input into the neural navigation system to show the correlation between anatomies of epileptogenic zone and cortex in functional area.Microsurgery was performed by neuronavigation and iEEG location.Epileptogenic zone was extensively removed to minimize damages to the functional area. Results The patients were followed up for 2-26 months.Engel Ⅰ-Ⅲ were achieved in 13,2,and 1 cases,respectively,with no neurological dysfunction occurred after operation. Conclusion Combined intracranial electrode monitoring and neuronavigation is more accurate for intractable epilepsy surgery with less invasion.

     

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