Stereotactic Hippocampal Deep Electrodes Implanted In The Application Of Temporal Lobe Epilepsy Surgery

Objective To discuss the value of stereotactie implanting hippocampal depth EE Gs monitoring to localize the epileptogenic zone in temporal lobe epilepsy.Methods Select January 2011-January 2014 15 cases of temporal lobe epileps y patients during the neurosurgery, including 9 males and 6 females, aged 18 to 38 years, mean 26 years, duration of 8 to 20 years, an average of 16 years. All patients were diagnosed as refractory temporal lobe epilepsy, through neuroimagi ng, and neuropsychological assessment, except intracranial vascular malformations clear focal lesions.15 patients,generalized tonic-spastic episodes four cases,8 c ases of complex partial seizures, partial seizures with secondary generalized seizu res in 3 cases. Other symptoms of fear, hallucinations or indescribable epigastric discomfort attack other three cases. With previous:encephalitis, meningitis history of five cases, a history of fever in 3 cases,2 cases of kernicterus history, a hist ory of two casesof perinatal syndrome, I have not found a clear cause. Multiples equence whichcranial MRI examination:6 patients with bilateral or unilateral hip pocampal region see increased signal but it is difficult to confirm the diagnosis of hippocampal sclerosis, including bilateral in two cases, a simple right of the 3 cases,1 case purely on the left, I did not see obvious radiographic abnormalit ies. Scalp long-range monitoring VEEG:Attack of the 10 patients between no de finite epileptiform EEG waveforms,5 patients see scattered spikes, sharp waves or sharp and slow wave complexes in the temporal lobe area, including three ca ses with MR imaging contrary; monitor the clinical onset of 11 cases, the tempo ral lobe region gradually increased slow wave amplitude and scalp EEG spikesap pear in the episode, but left when the right hemisphere orquickly spread toboth s ides, it is difficult when the exact temporal area were fixed side positioning.The depth electrodes were implanted in hippocampus in the guidance of MR and ster eotactic in 15 patients with temporal lobe epilepsy, whose epileptogenic zone we re difficulty to be localized or lateralized. Using video eeg monitoring to tracesta ge attacks and attacks between electroencephalogram.Epileptogenic zones were det ermined according to the monitoring results, and adopted individualized epilepsy surgery,regular oral antiepileptic drugs and follow-up after surgery.Results The longest postoperatie obseration period was 44 months, the shortest8 months, an average of 21 months. The following-up outcomes showed that the satisfaction were 8 cases (54%), significant improvements were 5 cases(33%), go od was two cases(13%).There were no serious complications.Only one patient p ostoperative appeared with visual field defect.Conclusions To record hippocampal EEG in patients with intractable epilepsy b y stereotactic implanting depth electrode into the hippocampus is a minimally inv asive, safe and accurate method to localize lateralize epileptogenic zones in patie nts with temporal lobe epilepsy.It has a decisive role in formulate individualized operation scheme.