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目的探索颞叶内侧型癫痫海马杏仁复合体区发作间期痫性放电的特征与范围,为立体定向射频毁损提供可靠依据。方法 235例经多导长程视频脑电加偶极子定位检查提示为颞叶内侧型癫痫患者,经机器人辅助定位在海马杏仁复合体区植入深部电极,监测并分析其放电特征与范围,根据监测结果实施射频毁损术。结果 235例患者均检测到发作间期的痫性放电,共6种形式;痫性放电中心部位波动于靶点下20 mm至靶点上10mm。平均位于靶下6.3507±5.0325 mm。放电范围在垂直于颞叶长轴方向为5~35 mm,平均14.2639±5.1011mm。颅底与放电中心的距离波动于2~25 mm,平均为9.0097±2.9232 mm。结论颞叶内侧型癫痫的痫性放电部位与传统定位的靶点有一定差异,且放电范围各不相同,应以深部电极监测结果实施毁损。
Objective To explore the characteristics and scope of epileptic discharge during the interictal epilepsy in the hippocampal almond complex of temporal lobe medial epilepsy and provide a reliable basis for stereotactic radiofrequency ablation. Methods Totally 235 patients with temporal lobe medial epilepsy were inspected by multi-channel long-range video EEG plus dipole. The deep electrodes were implanted in the almond complex of hippocampus with the help of robot. The characteristics and range of discharge were monitored and analyzed. Monitoring results of the implementation of radio frequency destructive surgery. Results All the 235 patients detected seizure discharge in the interictal period. There were 6 forms in total. The center of epileptic discharge fluctuated from 20 mm below the target to 10 mm above the target. Averaging 6.3507 ± 5.0325 mm below the target. The discharge range is 5 ~ 35 mm perpendicular to the long axis of the temporal lobe with an average of 14.2639 ± 5.1011 mm. The distance between skull base and discharge center fluctuated from 2 to 25 mm with an average of 9.0097 ± 2.9232 mm. Conclusion The epileptic discharge in the medial temporal epilepsy is different from the traditional target. The discharge range is different, and the damage should be done by the monitoring results of the deep electrode.