关键词: 立体定向脑电图, 射频热凝毁损术, 中央区癫痫, 药物难治性癫痫, 回顾性分析

Abstract: Objective To explore the efficacy and safety of stereotactic electroencephalography (SEEG)-guided radiofrequency thermocoagulation ablation in the treatment of refractory central zone epilepsy. Methods A retrospective analysis was conducted on 9 patients with refractory central zone epilepsy confirmed by SEEG from March 2019 to March 2024.The relationship between epileptogenic foci and functional cortex was precisely located in three-dimensional space.SEEG-guided radiofrequency thermocoagulation ablation was performed on the clearly identified epileptogenic initiation zone under awake conditions.Postoperative follow-up was conducted regularly,and the prognosis of patients was evaluated according to the Engel classification,as well as the status of epileptic seizures and neurological function impairment. Results A total of 70 electrodes were implanted in 9 patients.According to the SEEG results,45 electrodes were thermocoagulated.After 12 months of follow-up after thermocoagulation,6 patients (66.67%) were classified as Engel I,1 patient (11.11%) as Engel II,1 patient (11.11%) as Engel III,and 1 patient (11.11%) as Engel IV.The total effective rate (Engel I-III) was 88.89%.One patient had postoperative bleeding in the surgical area,one had facial paralysis,and eight had decreased muscle strength in one limb.After treatment with hyperbaric oxygen and limb rehabilitation,only one patient had slightly poor fine finger movement,and the neurological functions of the other patients were restored. Conclusion Radiofrequency thermocoagulation under SEEG guidance is an effective,minimally invasive and relatively safe method for treating intractable central zone epilepsy,and it has clinical promotion value.

Key words: Stereotactic electroencephalography, Radiofrequency thermocoagulation ablation, Central zone epilepsy, Drug-resistant epilepsy, Retrospective analysis