Abstract: Objective To investigate the Leksell framework stereotactic eeg (L - SEEG,Leksell-stereoelectroencephalography.) technology,the positioning island wild leaf and suspicious application of lobe epilepsy.Methods In ten epileptic patients,83 SEEG electrodes were implanted using the Leksell frame,per average (8 ± 2) root,including 984 contacts,38 electrodes involving the insula and 151 contacts.After implantation,the Nicolet 256 guided EEG system was used for long-range video EEG monitoring,and more than 3 habitual episodes occurred.Epictal and interictal figures were recorded to identify the epileptic foci.Results In this group of 10 patients,the onset of scalp EEG was temporal lobe or frontal lobe,but the onset of intracranial EEG was insula lobe.Among them,suspected insular attack,intracranial EEG starting from temporal lobe or frontal lobe;All 10 patients underwent surgical resection of epileptogenic foci.In this group,there were no complications caused by electrode implantation,such as electrode removal,intracranial hematoma and intracranial infection.The patients were followed up for 1~3 years and given 1~3 kinds of antiepileptic drugs.Engel grading was performed according to the postoperative results,including 6 cases of grade I,3 cases of grade II,and 1 case of grade III.Conclusion L-SEEG has less trauma,fewer complications and is accurate.It can be used in suspected insular epilepsy to identify epileptogenic foci and improve the cure rate.

Key words: Epilepsy, The insula, Intracranial electrode, Stereotactic electroencephalography, L - SEEG framework

摘要： 目的 探讨Leksell框架立体定向脑电图(L-SEEG,Leksell--stereoelectroencephalography.)技术,在定位岛叶及可疑岛叶癫痫中的应用。方法 回顾10例癫痫患者,使用Leksell框架共植入83根SEEG电极,每人平均植入(8±2)根,其中触点984个,其中涉及岛叶的电极38根,触点数共 151个。植入后均采用Nicolet 256 导脑电系统进行视频脑电图长程监测,均出现 3 次以上惯常发作。记录发作期及发作间期图形,明确致痫灶。结果 本组病例10位患者,头皮脑电图起始为颞叶或额叶,但颅内脑电图发作起始为岛叶;其中可疑岛叶发作,颅内脑电图起始为颞叶或额叶。10位患者均行手术切除致痫灶治疗。该组病例中未出现电极折断、颅内血肿、颅内感染等植入电极引起的并发症。随访1~3年,术后给予1~3种抗癫痫药物。根据术后效果分级进行 Engel 分级,I级者6例,II级者3例,Ⅲ级者1例。结论 L-SEEG创伤小,并发症少,准确,应用在疑似岛叶癫痫中,可以确定致痫灶,提高治愈率。

关键词: 癫痫, 岛叶, 颅内电极, 立体定向脑电图, L-SEEG框架