Abstract: Objective To explore the epilepsy form,transmission network,diagnosis and treatment methods of supplementary motor area epilepsy.Methods The clinical data of a patient with epilepsy in the supplementary motor area diagnosed and treated with the aid of stereotaxic technology in our department were sorted out,and the clinical symptoms,EEG transmission network and treatment effect were analyzed in combination with domestic and foreign literature.Results After the first-stage evaluation of epilepsy,the patient was determined to undergo SEEG surgery assisted by stereotaxic technology,and entered the second-stage evaluation of epilepsy before epilepsy.After more than 2 months of observation,the patient's seizures increased.After the preoperative evaluation of epilepsy in the first two phases was reviewed again,the epilepsy foci resection was performed under the guidance of neuronavigator and cortical EEG,and the patient was seizure-free 18 months after operation.Conclusion The epileptic discharges from the supplementary motor area are rapidly transferred to the contralateral side through the corpus callosum,and the symptoms appear on both sides of the corpus callosum at the same time.Preoperative comprehensive evaluation cannotdetermine the location of epileptic focus,SEEG localization should be performed.Incomplete thermal coagulation can lead to aggravation of Epilepsy in the supplementary motor area.After excision of the epileptic foci in one SMA area,the patient's language and contralateral limb dysfunction did not appear.

Key words: Refractory epilepsy, Supplementary motor area, Stereotactic technology, SEEG, Epilepsy fociectomy

摘要： 目的 探讨辅助运动区癫痫的发作形式,传播网络和诊治方法。方法 整理我科在立体定向技术辅助下诊治的一例辅助运动区癫痫患者的临床资料,结合国内外文献分析其临床症状、脑电传播网络和治疗效果。结果 患者经过癫痫术前一期评估后,确定在立体定向技术辅助下行SEEG手术进入癫痫术前二期评估,依据立体脑电图监测结果分析讨论后,行射频热凝治疗,热凝术后观察2月余,患者癫痫发作增多。再次总结分析前两期的癫痫术前评估结果后,在神经导航仪和皮质脑电图引导下行致癫灶切除术,患者术后18个月无发作。结论 辅助运动区癫痫放电迅速经胼胝体传入对侧,症状同时出现在胼胝体两侧。术前综合评估不能明确致癫灶位置,则需行SEEG定位。不彻底和不全面的热凝可导致辅助运动区癫痫发作加重。一侧SMA区致癫灶切除后,不会出现患者语言和对侧肢体功能障碍。

关键词: 难治性癫痫, 辅助运动区, 立体定向技术, 立体脑电图, 致癫灶切除术