SUBDURAL AND DEPTH ELECTRODES IN THE PRESURGICAL EVALUATION OF EPILEPSY
SUBDURAL AND DEPTH ELECTRODES IN THE PRESURGICAL EVALUATION OF EPILEPSY
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DOI：
10.1007/bf01400656
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发表时间：
1994-01-01
影响因子：
2.4
通讯作者：
SCHRAMM, J
中科院分区：
文献类型：
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作者：
BEHRENS, E;ZENTNER, J;SCHRAMM, J
从1987年到1992年，我们对160例医学上难治性癫痫患者进行了硬脑膜下条带、栅格或深度电极的有创脑电图研究，这些患者的头皮脑电图不足以定位致痫灶。根据个人要求，这些不同的电极类型可以单独使用或组合使用。157例患者通过钻孔植入4 ~ 16个触点的多个条状电极，15例患者通过骨瓣植入64个触点的网格电极，36例患者采用立体定向方法植入海马内深度电极。在每个病例中，电极相对于大脑结构的定位是由CT扫描和MRI控制的。术外记录的视觉和计算机分析允许143例（89%）患者定位可切除的癫痫灶，随后转介手术，而17例（11%）患者不得不拒绝手术。在我们的研究中，我们没有发现任何永久性的发病率或死亡率。根据我们的经验，长期植入电极的脑电图监测是一种可行的技术，它本质上有助于癫痫灶的精确定位，因为它可以几乎无人工地记录发作和间歇期的活动。此外，网格电极可以用于手术外的功能地形图绘制的雄辩的大脑区域。
From 1987 to 1992, invasive EEG studies using subdural strips, grids or depth electrodes were performed in a total of 160 patients with medically intractable epilepsy, in whom scalp EEG was insufficient to localize the epileptogenic focus. Dependent on the individual requirements, these different electrode types were used alone or in combination. Multiple strip electrodes with 4 to 16 contacts were implanted in 157 cases through burrholes, grids with up to 64 contacts in 15 cases via boneflaps, and intrahippocampal depth electrodes in 36 cases using stereotactic procedures. In every case, localization of the electrodes with respect to brain structures was controlled by CT scan and MRI.Visual and computerized analysis of extra-operative recordings allowed the localization of a resectable epileptogenic focus in 143 patients (89%), who subsequently were referred for surgery, whereas surgery had to be denied to 17 patients (11%). We did not encounter any permanent morbidity or mortality in our series.In our experience, EEG-monitoring with chronically implanted electrodes is a feasible technique which contributes essentially to the exact localization of the epileptogenic focus, since it allows nearly artefact-free recording of the ictal and interictal activity. Moreover, grid electrodes can be used for extra-operative functional topographic mapping of eloquent brain areas.