迷走神经刺激术-程控电刺激治疗难治性癫痫

目的 应用迷走神经刺激术(vagus nerve stimulation,VNS)治疗难治性癫痫,并探讨其治疗机制和方法。方法 个体化的VNS疗效预测和精确无误的VNS植入,适时恰当的刺激参数程控调校,并以长程脑电图、SPECT观测VNS带来的脑功能改变。结果 接受VNS术3个月后,3例病患的发作频次均减少50％以上,2例在应急磁铁的辅助下基本不再表现复杂性发作,1例不再表现全身失张性发作,而以部分性发作为主,偶有复杂发作,生活质量提高。脑电图原有的棘波、尖波消失或减少,阵发性异常消失或时间缩短。发作间期SPECT表现为原有的低代谢灶缩小。结论 恰当地应用VNS能够为难治性癫痫提供一种有效、微创、副作用极少的治疗手段。

Vagus nerve stimulation - program control eletricity stimulation treatment refractory epilepsy

Objective To study vagus nerve stimulation(VNS) for refractory epilepsy and research the mechanism of VNS curative effect.Methods Patient identification qualification(PIQ)(search from-patient outcome registry profile patient 3 & 12 months visit) and choice of adaptive cases,the minimal injured without any mistake to plant VNS,the adjust at the right time and in the right stimulation parameter for refractory epilepsy,to evaluate the change of the brain function due to the effect of VNS using the long time video EEG and SPECT.Results The seizure frequency of the three cases degrade to over 50% after the VNS operation three months later,the two cases almost would not have the complex partial seizures(CPS) aided by the magnet for meeting the emergency,and the third case would not drop attack any more,instead of simple partial seizures(SPS),the CPS appears occasionally.The spikes and shapes which existed on the EEG degrade or disappear now,the paroxysmal abnormity waves disappear or it lasted for shorter time.The hypometabolism focus which existed in SPECT has reduced in interictal.Conclusion The right usage of VNS offer an effective,minimal injured,reversible,almost no poisonous and side-effect cure method for refractory epilepsy.