Treatment of Epilepsy Associated with Periventricular Nodular Heterotopia
Treatment of Epilepsy Associated with Periventricular Nodular Heterotopia
复制标题
DOI：
10.1007/s11910-020-01082-y
复制
发表时间：
2020-10
影响因子：
5.6
通讯作者：
H. M. Khoo;J. Gotman;Jeffery A. Hall;F. Dubeau
中科院分区：
文献类型：
--
作者：
H. M. Khoo;J. Gotman;Jeffery A. Hall;F. Dubeau
综述目的：室周结节性异位（PNH）相关癫痫是一种发育畸形，常耐药，需要局部治疗干预。侵入性脑电图研究通常是必要的，以划定致痫灶，但建立一个准确的假设，以确定适当的电极植入方案和治疗是具有挑战性的。本文回顾了最近的研究，有助于了解癫痫的发生和潜在的治疗方案在PNH.Recent FindingsNew非侵入性诊断和脑内EEG分析工具表明，皮质过度兴奋性和异常连接（结节和皮质之间和结节之间）是可能的机制，导致癫痫在大多数患者。深坐PNH，如果癫痫，是立体定向消融技术的理想目标，它提供了伴随消融多个区域与相对满意的seizure outcome.SummaryAdvance在诊断和分析工具，提高了我们的理解复杂的癫痫PNH。立体定向消融技术的发展为这些患者提供了有前途的治疗选择。
Purpose of ReviewEpilepsy associated with periventricular nodular heterotopia (PNH), a developmental malformation, is frequently drug-resistant and requires focal therapeutic intervention. Invasive EEG study is usually necessary to delineate the epileptogenic zone, but constructing an accurate hypothesis to define an appropriate electrode implantation scheme and the treatment is challenging. This article reviews recent studies that help understanding the epileptogenicity and potential therapeutic options in PNH.Recent FindingsNew noninvasive diagnostic and intracerebral EEG analytic tools demonstrated that cortical hyperexcitability and aberrant connectivity (between nodules and cortices and among nodules) are likely mechanisms causing epilepsy in most patients. The deeply seated PNH, if epileptogenic, are ideal target for stereotactic ablative techniques, which offer concomitant ablation of multiple regions with relatively satisfactory seizure outcome.SummaryAdvance in diagnostic and analytic tools have enhanced our understanding of the complex epileptogenicity in PNH. Development in stereotactic ablative techniques now offers promising therapeutic options for these patients.