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目的探讨颅内电极埋藏术后进行视频脑电图评估在癫痫外科手术致痫灶定位困难的Lennox-Gastaut综合症中的使用。方法收集10例Lennox-Gastaut综合症致痫灶定位困难的患者,向颅内硬膜下植入条状电极,术后进行视频脑电图评估,记录发作间歇期及发作期脑电图变化,确定癫痫病灶的起始区,通过手术方式切除致痫灶。结果本组10例患者埋藏时间为2～7天,平均4天,均记录到间歇期及发作期脑电图情况。根据脑电图结果,行脑叶切除及胼胝体切开。术后按照Engel评分I级4例,II级2例,III级2例,IV级2例。所有病例均未出现埋藏电极引起的严重并发症。结论在致痫灶定位困难的Lennox-Gastaut综合症中,采用颅内电极埋藏进行视频脑电图检测,可以较准确定位主要致痫灶,从而提高Lennox-Gastaut综合症外科治疗有效率。
Objective To investigate the use of video EEG assessment after intracranial electrode burial in Lennox-Gastaut syndrome, which is difficult to locate epileptic foci in epilepsy surgery. Methods Ten patients with focal necrosis of Lennox-Gastaut syndrome were enrolled in this study. Strip electrodes were implanted into the intracranial dura mater. Video EEG assessment was performed after operation. Changes of seizure interval and period of EEG were recorded. Determine the starting area of epileptic lesions, surgical removal of epileptogenic lesions. Results The group of 10 patients buried for 2 to 7 days, an average of 4 days, were recorded intermittent and episodes of EEG. According to the results of electroencephalography, lobectomy and corpus callosum incision. According to Engel score, 4 cases were grade I, 2 cases were grade II, 2 cases were grade III and 2 cases were grade IV. No serious complications caused by the buried electrode occurred in all cases. Conclusion In the Lennox-Gastaut syndrome, which locates in the focal epileptogenic zone, intracranial electrode burial is used to detect the video-electroencephalogram (EEG), which can locate the main epileptogenic zone more accurately and improve the efficiency of surgical treatment of Lennox-Gastaut syndrome.