Description of Ictal HFO Mapping in Patients with Both Temporal and Extratemporal Seizure Focus.
Description of Ictal HFO Mapping in Patients with Both Temporal and Extratemporal Seizure Focus.
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DOI：
10.1155/2016/5380907
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发表时间：
2016
影响因子：
1.5
通讯作者：
Rusyniak WG
中科院分区：
文献类型：
--
作者：
Ochoa JG;Rusyniak WG
目标。回顾手术前使用颅尖HFO测图来检测颞叶和颞外皮层中具有双重发作焦点的颅尖激活区。方法。回顾2014年1月至2015年10月在南阿拉巴马大学癫痫监测中心（SouthCEP）连续收治的疑似颞叶癫痫并有颅内电极记录的患者。通过植入电极的患者自身共注册磁共振成像（MRI）和计算机断层扫描（CT），在3D重建脑图像中显示初始HFO定位。结果。15例患者中有4例在临床发作时表现出颞外受累的迹象。包括额叶和颞叶的初始HFO定位改变了三个患者的手术切除区域，这些患者最初的手术计划只包括颞叶。在所有患者中，在癫痫发作和初始传播区切除初始HFO与癫痫发作自由相关；随访期为12 ~ 25个月。的意义。颞外颞叶受累可能没有临床表现，可能是颞叶癫痫手术失败的原因。颅顶HFO映射有助于定义颅顶皮层网络，并有助于检测颞外病灶。
Objective. Review presurgical use of ictal HFO mapping to detect ictal activation areas with dual seizure focus in both the temporal and extratemporal cortex. Methods. Review of consecutive patients admitted to the University of South Alabama Epilepsy Monitoring Unit (SouthCEP) between January 2014 and October 2015, with suspected temporal lobe epilepsy and intracranial electrode recording. Ictal HFO localization was displayed in 3D reconstructed brain images using the patient's own coregistered magnetic resonance imaging (MRI) and computed tomography (CT) with the implanted electrodes. Results. Four of fifteen patients showed evidence of extratemporal involvement at the onset of the clinical seizures. Ictal HFO mapping involving both frontal and temporal lobe changed the surgical resection areas in three patients where the initial surgical plan included only the temporal lobe. Resection of the ictal HFO at the onset of the seizure and the initial propagation region was associated with seizure freedom in all patients; follow-up period ranged from 12 to 25 months. Significance. Extratemporal ictal involvement may not have clinical manifestations and may account for surgical failure in temporal lobe epilepsy. Ictal HFO mapping is useful to define the ictal cortical network and may help detect an extratemporal focus.