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find Keyword "立体脑电图" 6 results
  • The analysis of insula lobe function based on the Stereo-electroencephalography

    ObjectiveTo understand the relationship between the anatomy and the function of the insula lobe cortex based on the stereo-electro encephalography (SEEG) by direct electric stimulation of the insula cortex performed in the patients who suffered from the refractory epilepsy. MethodsRetrospective review was performed on 12 individuals with refractory epilepsy who were diagnosed in the Department of Functional neurosurgery of RenJi Hospital from December 2013 to September 2015. We studied all the SEEG electrodes implanted in the brain with contacts in the insula cortex. Direct electric stimulation was given to gain the brain mapping of the insula. Results12 consecutive patients with refractory epilepsy were implanted SEEG electrodes into the insula cortex. In all, 176 contacts were in the insula cortex, and 154 were included. The main clinical manifestations obtained by the stimulation were somatosensory abnormalities, laryngeal constriction, dyspnea, nausea, flustered. While somatosensory symptoms were located in the posterior insula, visceral sensory symptoms distribute relatively in the anterior insula, and other symptoms were mainly in the central and anterior part. ConclusionsThe symptoms of the insula present mainly according to the anatomy, but some of them are mixed. In addition, the manifestations of the insula are usually complex and individually.

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  • A comparative study on the value of stereo-electroencephalography and subdural cortical electrodes monitoring in preoperative evaluation of epileptogenic zone: stereo-electroencephalography with less complication of hemorrhage and infection

    ObjectiveThe purpose of this study was to compare the value of SEEG and subdural cortical electrodes monitoring in preoperative evaluation of epileptogenic zone. MethodsFeatures of patients using SEEG (48 cases) and subdural cortical electrodes monitoring (52 cases) to evaluate the epileptogenic zone were collected from June 2011 to June 2015. And the evaluation results, surgical effects and complications were compared. ResultsThere was no significant difference between SEEG and subdural cortical electrodes monitoring in identifying the epileptogenic zone or taking epileptic surgery, but SEEG could monitor multifocal and bilateral epileptogenic zone. And there was no significant difference in postoperative seizure control and intelligence improvement (P > 0.05). The total complication rate of SEEG was lower than subdural cortical electrodes monitoring, especially in hemorrhage and infection (P < 0.05). ConclusionsThere was no difference among SEEG and subdural cortical electrodes monitoring in surgical results, but SEEG with less hemorrhagic and infectious risks. SEEG is a safe and effective intracranial monitoring method, which can be widely used.

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  • Characteristics of motor semiology of epileptic seizure originated from dorsolateral frontal lobe:an analysis based on stereoelectroencephalography

    ObjectiveTo investigate characteristics of motor semiology of epileptic seizure originated from dorsolateral frontal lobe. MethodsRetrospectively analysis the clinical profiles of patients who were diagnosed dorsolateral frontal lobe epilepsy (FLE) based on stereoelectroencephalography (SEEG) and underwent respective surgeries subsequently. Component of motor semiology in a seizure can be divided into elementary motor (EM, include tonic, versive, clonic, and myoclonic seizures) and complex motor (CM, include automotor, hypermotor, and so on). A Talairach coordinate system was constructed in the sagittal series of MRI images in each case. From the cross point of VAC and the Sylvian Fissure, a line was drawn antero-superiorly, which made an angle of 60° with the AC-PC line, then the frontal lobe could be divided into anterior and posterior portion. The epileptogenic zone, which was defined as ictal onset and early spreading zone in SEEG, was classified into three types, according to the positional relationship of the responding electrodes contacts and the "60° line": the anterior, posterior, and intermediate FLE. The correlation of the components of motor semiology in seizures and the location of the epileptogenic zone was analyzed. ResultsFive cases (26.3%) were verified as anterior FLE, among which there were 2 of EM, one of CM, and 2 of EM+CM. In 7 cases (36.8%) of intermediate FLE, there were one of EM, none of CM, and 6 of EM+CM. In the rest 7 cases of posterior FLE, there were 6 of EM, none of CM, and one of EM+CM. Compared with the cases that the epileptogenic zone involved anterior portion, the posterior FLE is more likely to present EM seizures (85.7%), and less likely to show CM components (P < 0.05). And Compared with the anterior FLE and posterior FLE, the intermediate FLE is more likely to present EM+CM seizures (85.7%)(P < 0.05). ConclusionThe motor seizure semiology of dorsolateral FLE has significant correlation with the localization of the epileptogenic zone. Posterior FLE mainly present a pure elementary motor seizure, and once the epileptogenic zone involved anteriorly beyond the "60° line", the component of complex motor seizure would be seen. Intermediate FLE, as its specialty of transboundary, is more likely to show "comprised semiology" of EM and CM. Construction of the "60° line" with AC-PC coordinate system in the MRI images may play an useful role in semiology analysis in presurgical evaluation of FLE.

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  • 癫痫网络的定义:立体脑电图和信号分析的贡献

    致痫网络定义为癫痫放电产生和传播过程中累及的脑区。基于颅内电极电生理数据的分析,文章综述介绍了致痫网络的历史、方法和概念。在癫痫术前评估中,确定产生癫痫发作的脑区(如致痫区)是最重要的目标。较药物难治性局灶性癫痫传统的、局限性的视觉分析方法而言,致痫网络作为一个模型已逐渐得到公认。该模型能更好地描述发作动态演变的复杂性、更真实地描述大脑致痫性的异常分布。致痫网络概念在历史上与立体脑电图(SEEG)方法学的发展及随后脑电信号定量分析相关。SEEG 有明确的发作期、发作前及发作间期放电模式,可以用信号分析方法对上述模式进行分析,如高频振荡定量分析或分析功能连接的改变。我们可以在皮层和皮层下脑区癫痫发生和传播的过程中,依据 SEEG 数据分析得到大脑连接的显著变化,这些变化与不同的发作症状学模式相关。发作间期特征就是致痫网络产生异常电活动(发作间期棘波)及功能连接的改变。致痫网络大尺度建模新方法的引入为更好地预测手术预后提供了新方法。就明确致痫性脑区的分布而言,致痫网络的概念是一个关键的要素,这对癫痫手术尤为重要。

    Release date:2018-03-20 04:09 Export PDF Favorites Scan
  • 立体脑电图颅内电极植入的准确性:系统评价和 Meta 分析

    立体脑电图(SEEG)是一种将电极植入大脑以帮助确定致痫灶的操作。它是在非侵入性检查不能确定致痫灶的情况下,对耐药性局灶性癫痫患者进行明确的癫痫手术之前进行的。这项操作的主要风险是出血,发生率为 1%~2%,可能原因是电极放置不准确,或者计划的植入电极损伤了在术前血管成像中未检测到的血管。推荐的电极植入技术包括:使用立体定向框架、无框架影像导航系统、机器人导航系统和定制的患者固定装置。研究参照系统评价和 Meta 分析推荐报告条目(Preferred reporting items for systematic reviews and Meta-analysis,PRISMA),结构化搜索 PubMed、Embase 和 Cochrane 数据库,纳入的研究涉及:①SEEG 电极植入作为术前工作的一部分;② 针对耐药性局灶性癫痫患者;③ 提供准确数据。数据库检索出 326 篇文章,删除重复和非英语语言的研究后,筛选出 293 篇文章。应用纳入和排除标准后,最终有 15 项研究纳入定性和定量分析。利用随机效应的元分析和技术分层,最终总结出 SEEG 电极植入的准确性。发表有关 SEEG 植入技术的准确性文献有限。目前并没有比较不同 SEEG 植入技术的前瞻性对照临床试验。在已确定的研究之间存在显著的系统异质性,妨碍了各项技术之间有意义的比较。最近引进的机器人导航系统被认为提供了一种更精确的植入方法,但支持证据仅限于 3 级。在将新技术引入进行广泛临床应用之前,有必要通过良好设计、方法合理的研究将新技术与以前的“金标准”进行比较。

    Release date:2018-09-18 10:17 Export PDF Favorites Scan
  • SEEG-guided radiofrequency thermocoagulation in the treatment of bilateral posterior cortex epilepsy: a case report and review of the literature

    ObjectiveTo explore the clinical value of SEEG-guided radiofrequency thermocoagulation therapy in patients with posterior cortex epilepsy.MethodsA case of epilepsy secondary to viral encephalitis was reported in this paper, SEEG implantation confirmed that the seizure began in bilateral posterior head, and the right posterior head was the main area of disabling lesion. After a series of complete preoperative neuropsychological assessment, the right posterior head was found to have functional retention. Therefore, we used a minimally invasive radiofrequency thermocoagulation therapy to damage epileptic foci.ResultsThe patient were followed up for 2 years after operation, the seizure frequency were significantly reduced, and the patients did not show symptoms of functional loss.ConclusionPosterior cortex epilepsy is common in neonates with brain injury. The localization and lateralization of operation is difficult because its EEG showed bilateral discharges, or the seizures start from both sides of posterior head, meanwhile, posterior head involves functional areas, which makes the operation even more difficult. This minimally invasive treatment destroys the lesion and maximizes the protection of the patient's functional areas, which provides a new surgical approach for bilateral posterior cortex epilepsy in the future, especially for symptomatic epilepsy caused by hypoxic-ischemic brain injury and encephalitis.

    Release date:2021-01-07 02:57 Export PDF Favorites Scan
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