[1]陈俊喜　郭　强　谭红平　王艮波　华　刚.ROSA引导下立体定向脑电图在儿童难治性癫痫手术中作用[J].中国临床神经外科杂志,2017,(09):623-625629.[doi:10.13798/j.issn.1009-153X.2017.09.005]
　CHEN Jun-xi,GUO Qiang,TAN Hong-ping,et al.Application of ROSA-guided stereoelectroencephalography surgery for intractable epilepsy in children[J].,2017,(09):623-625629.[doi:10.13798/j.issn.1009-153X.2017.09.005]
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ROSA引导下立体定向脑电图在儿童难治性癫痫手术中作用()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2017年09期
页码:
623-625629
栏目:
论著
出版日期:
2017-09-25

文章信息/Info

Title:
Application of ROSA-guided stereoelectroencephalography surgery for intractable epilepsy in children
文章编号:
1009-153X（2017）09-0623-03
作者:
陈俊喜　郭　强　谭红平　王艮波　华　刚
510510 广州，广东三九脑科医院癫痫外科
Author(s):
CHEN Jun-xi;  GUO Qiang;  TAN Hong-ping;  WANG Geng-bo;  HUA Gang
Department of Epilepsy Surgery, Guangdong 999 Brain Hospital, Guangzhou 510510, China
关键词:
药物难治性癫痫; 儿童; 颅内电极置入术; 机器人无框架立体定向辅助系统
Keywords:
Intractable;  Epilepsy;  Children;  intracranial electrode;  ROSA-guided stereoelectroencephalography
分类号:
R 742.1; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2017.09.005
文献标志码:
A
摘要:
目的 探讨机器人无框架立体定向手术辅助系统（ROSA）引导下颅内深部电极置入术在儿童难治性癫痫定位中的作用以及安全性、有效性。方法 2014年10月至2015年12月收治19例年龄在14岁以下药物难治性癫痫，经过术前无创评估，包括MRI、头皮脑电图、电-临床症状学、PET-CT等，应用ROSA机器人将电极置入颅内相应部位，然后行长程视频脑电图监测发作间期及发作期脑电图，确定癫痫灶起始，最终手术治疗。结果 19例患儿均成功置入电极，左侧置入11例，右侧置入7例，双侧置入1例；共置入深部电极222根，平均11.7根（8~17根）。置入电极后无出血、脑脊液漏、电极断裂、感染等并发症。19例均明确致痫灶，并全部行癫痫灶切除术，术后2例出现一过性轻偏瘫。术后随访12~24个月，Engel分级Ⅰ级15例（78.9%），Ⅱ级1例（5%），Ⅲ级1例（5%），Ⅳ级2例（11.1%）。结论 ROSA引导下立体定向脑深部电极置入术，微创、并发症少、安全性高，适合儿童难治性癫痫的外科治疗。
Abstract:
Objective To explore the safety of intracranial electrode implantation under help of Robotized stereotactic assistant (ROSA) -guided stereoelectroencephalography (SEEG) and its value to surgery for intractable epilepsy in children. Methods Nineteen children under 14 years of age with intractable epilepsy were preoperatively assessed by MRI, video-EEG, PET-CT and so on and then the implantation of intracranial electrode, by which the long-term intracranial EEG was recorded, was performed under the help of ROSA-guided SEEG in order to locate the epileptogenic zone. The surgery was performed after the location of the epileptogenic zone in all the patients. Results A total of 222 intracranial electrodes were successfully implanted in all the children. The electrodes were implanted in the left cerebral hemisphere in 11 children, in the right ones in 7 and in bilateral ones in 1. There were no complications such as bleeding, cerebrospinal fluid leakage, electrode fracture and infection in all the children after the implantation. The epileptogenic zones were exactly located and successfully resected by surgery in all the children. Two patients had transient hemiparesis after the surgery. The following up from 12 to 24 months showed that the epileptic control effect was Engel grade Ⅰ in 15 children, grade Ⅱ in 1, grade Ⅲ in 1 and grade Ⅳ in 2. Conclusions The intracranial electrode implantation under the help of ROSA-guided SEEG is safe and may decrease in the postoperative complications and improvement of prognosis in the children with intractable epilepsy.

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备注/Memo

备注/Memo:
作者单位：510510 广州，广东三九脑科医院癫痫外科（陈俊喜、郭　强、谭红平、王艮波、华　刚）
更新日期/Last Update: 1900-01-01