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find Keyword "SEEG" 5 results
  • 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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  • A clinical study based on SEEG: epileptogenic mapping and surgery in pharmaco-resistant post-encephalitic temporal lobe epilepsy

    ObjectivesPost-encephalitic epilepsy could be of great chance of pharmaco-resistant, even surgery may not achieve seizure free. The aim of this study is to mapping epileptogenic area of pharmaco-resistant post-encephalitic temporal lobe epilepsy, to find whether "temporal plus" epilepsy is the main type and its surgery outcome, based on stereo-EEG(SEEG) study.MethodWe retrospectively studied 15 patients with pharmaco-resistant temporal lobe epilepsy. Scalp EEG, seizure semiology, MRI, FDG-PET, and SEEG were reviewed for all patients. According to epileptogenic area which was analysed by SEEG, 15 patients were divided into 2 groups, temporal lobe epilepsy(TLE) group and temporal plus epilepsy(TPE) group. Clinical characteristics were compared with each group, by t-test or Fisher exact test when data needed.ResultsThere were 8 patients in TLE group, with 6 mesial TLE, 1 lateral TLE, 1 mesial-lateral TLE. And 7 patients in TPE group. Age of seizure onset (P=0.548), duration of epilepsy (P=0.099), age of remote encephalitis (P=0.385), type of semiology (P=0.315) and lateralization of MR lesions (P=1.000), interictal FDG-PET hypometabalism (P=1.000) or intracranial implantation (P=0.619) were of no statistically difference between TLE group and TPE group. Surgery was performed in all patients. Better outcome was obtained in TLE group(5/8 class Ⅰ), and poor was in TPE group(3/7class Ⅰ).ConclusionMesial-TLE and temporal plus epilepsy were common types of pharmaco-resistant post-encephalitic TLE. There was no way to differentiate clinically, except by SEEG. Mesial-TLE had a better outcome after surgery, but temporal plus epilepsy did not.

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  • 癫痫的侵袭性术前评估

    癫痫切除手术前精确定位致痫灶至关重要,目前,对于综合无创性评估仍无法定位致痫灶或区分功能区的患者,国际上常采用硬膜下电极脑电图监测(Subduralel ectrodes EEG, SDEG)和立体定向脑电图(SEEG)两种侵袭性颅内脑电图(intracranial electroencephalography, iEEG)评估方法进一步定位致痫灶及区分功能区。SDEG 优势在于其相邻皮质覆盖连续性较好、皮层与电极的解剖关系清楚以及功能区定位相对容易;缺点主要在于对深部脑组织覆盖监测较差、癫痫起源的三维结构难以体现、双侧或相隔较远的多个区域植入困难以及创伤较大、并发症比例较高。SEEG 的优点在于定位深部皮质相对容易、癫痫起源的三维结构清楚、微创性高、适合双侧或相隔较远的多个区域植入;缺点在于相邻皮质覆盖连续性较差、功能区定位相对困难、植入过程中可损伤颅内血管导致颅内出血。近年来,iEEG 监测快速发展,但仍需进一步探索,如通过技术的不断改进及创新实现精确植入电极及降低植入并发症,通过设计临床前瞻性研究进一步研究 SDEG 和 SEEG 在定位致痫灶、切除范围及术后疗效的差异等。目前,SDEG 和 SEEG 在术前定位致痫灶方面各有优缺点,临床上应根据患者的具体情况个体化选择方案。

    Release date:2020-03-20 08:06 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
  • The discussion to improve the curative effect of stereo electroencephalogram-guided radiofrequency thermocoagulation for refractory epilepsy

    ObjectiveTo preliminarily explore the damage effect of stereo electroencephalogram-guided radiofrequency thermocoagulation after increasing the number of electrodes in the epileptic foci.MethodsEight cases were included from 42 patients requiring SEEG from the Department of Neurosurgery of the Second Hospital of Lanzhou University during June 2017 to Jan. 2019, of which 6 cases were hypothetical epileptogenic foci located in the functional area or deep in the epileptogenic foci that could not be surgically removed, 2 patients who were unwilling to undergo craniotomy; added hypothetical epileptic foci Electrodes, the number of implanted electrodes exceeds the number of electrodes needed to locate the epileptic foci. After radiofrequency thermocoagulation damages the epileptogenic foci, the therapeutic effect is analyzed.ResultsIn 8 patients, the number of implanted electrodes increased from 1 ~ 6, with an average of (4±2.2), and the number of thermosetting points increased by 2 ~ 10, with an average of (7±3.1); follow-up (9±3.2) months, Epilepsy control status: 3 cases of Engel Ⅰ, 3 cases of Engel Ⅱ, 2 cases of Engel Ⅲ; 8 cases of epileptic seizure frequency decreased≥50%. There was a statistically significant difference in the frequency of attacks before and after thermocoagulation (P<0.05).ConclusionsIncreasing the lesion volume of the epileptic foci can obviously improve the efficacy of epilepsy. SEEG-guided radiofrequency thermocoagulation is an effective supplementary method for classical resection.

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