病毒性脑炎后遗癫痫的致痢灶定位及射频热凝疗效 |
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引用本文: | 吴朝晖,田增民,赵全军,林鸿,尹丰,赵虎林.病毒性脑炎后遗癫痫的致痢灶定位及射频热凝疗效[J].临床神经电生理学杂志,2010,19(3):144-146. |
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作者姓名: | 吴朝晖 田增民 赵全军 林鸿 尹丰 赵虎林 |
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作者单位: | 第二军医大学海军临床医学院(海军总医院)神经外科,北京,100048 |
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摘 要: | 目的:总结用视频脑电图(V-EEG)监测病毒性脑炎后遗癫痫患者,以立体脑电辅助定位为基本依据进行机器人辅助立体定向作射频热凝毁损治疗的结果。方法:采用V-EEG监测病毒性脑炎症状体征稳定后6个月以上的药物难治性癫痫患者22例(其中因病史与无创检查矛盾,采用立体定位脑电监测1例)。结果:①22例患者都能在VEEG监测中发现痫样放电,分布均为两个脑区或以上(100%)(其中1例行立体脑电监测定位);②22例患者接受机器人辅助立体定向射频热凝毁损颞叶内侧结构或内囊前肢,随访6~36个月(平均15.4个月),发现癫痫发作消失(继续服术前药物情况下)1例(4.5%),极少或几乎消失(每6个月发作不超过1次)1例(4.5%),值得的改善(发作较术前减少90%或以上)0例,不值得的改善或无效20例(91%);③22例患者中16例行立体定向术后3d内发生低热症状(72.7%)。结论:绝大多数病毒性脑炎后遗癫痫患者致痫灶不是很局限的,难以明确定位,因而射频热凝疗效较差。
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关 键 词: | 病毒性脑炎 后遗症 癫痫 致痫灶 射频热凝治疗 |
To locate the epileptogenk zones of the patients with symptomatic epilepsy after viral cephalitis |
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Institution: | WU Zhaohui, TIAN Zengmin, ZHAO Ouanjun,et al Neurosugery Center, the General Hospital of Navy of PI.A , Beijing(100048 ) , China |
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Abstract: | Objective:To locate the epileptogenic zones of the patients with the sequel epilepsy after viral cephalitis by electroencephalography (EEG). Methods: Video-electroeneephrgraphy (V-EEG) was used to locate the epileptogenic zones of 21 patients, and stereo-electroencephalography(SEEG) was used for 1 patient. Results: In all patients,epileptiform discharges in 2 or more lobes on V EEG were found. Six to 36 months(mean= 15.4 months)after operations, 1 patient(4.5%) was seizure free with preoperative drugs, the seizure frequency decreased significantly (≥90%) in 1 patient(4.5%), and unchanged or worse in 20 patients(91%). Sixteen patients(72.7%) had mild febrilis(≤38.5℃) within 3 d after operations. Conclusion: The most epileptogenic zones of the patients with sequel epilepsy after viral cephalitis were locted insufficiently. |
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Keywords: | Viral cephalitis sequel Epilepsy Epileptogenic zone |
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