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目的探讨岛叶立体定向电极植入方法,观察与岛叶相关异常放电的传导通路。方法根据术前检查结果,其致痫灶可能与岛叶相关的患者,通过综合应用神经导航结合脑立体定向技术采用斜交法及正交法植入岛叶立体定向电极,并分析两种方法的利弊,结合其它立体定向电极,对岛叶相关的传导通路进行初步探讨。结果7例药物难治性癫痫患者岛叶植入立体定向电极17根,斜交法植入12根,平均每根电极在岛叶触点5.75个,正交法植入5根,平均每根电极在岛叶触点1.2个,经额及经顶联合植入可覆盖岛叶大部分脑回。监测发作期视频脑电图发现岛叶参与多条传导通路的传播。结论岛叶斜交法及正交法立体定向电极植入均安全可靠,且能证明岛叶相关异常放电传导通路。
OBJECTIVE To investigate the method of implanting island islets by stereotactic electrodes and observe the conduction path of abnormal discharge associated with island leaves. Methods According to the results of preoperative examination, the patients with epileptogenic lesions possibly associated with island leaves were treated with stereotaxic nerve guidance combined with stereotactic technique by oblique method and orthogonal method. Of the pros and cons, combined with other three-dimensional directional electrodes, island conduction pathways related to preliminary study. Results Seventeen patients with refractory epilepsy were implanted with stereotactic electrodes on the island and 12 implanted diaphragms. The average number of electrodes per island was 5.75 on the insula and 5 on the average. Electrodes in the island leaf contact 1.2, by the amount and the top joint implant can cover most of the insula toe. Monitoring of episodes of video EEG revealed that insulas were involved in the transmission of multiple pathways. Conclusion Islet oblique method and orthodontic stereotactic electrode implantation are both safe and reliable, and it can prove the island-leaf abnormal discharge conduction path.