| Objective:Application of stereotactic technique into deep electrode EEG monitoring to determine the induction of epilepsy in patients with intractable traumatic epilepsy,based on this to guide surgical treatment.Methods: Twelve patients with intractable traumatic epilepsy admitted to the Department of Neurosurgery at the Second Hospital of Lanzhou University from December 2015 to January 2018 were selected.All patients were diagnosed with refractory traumatic epilepsy.In 12 patients with intractable traumatic epilepsy,stereotactic deep electrodes were placed on the MRI localization guide.Video EEG monitoring recorded episodes and interictal EEGs according to recorded episodes and episodes.The EEG,combined with the clinical symptoms of the patient’s seizure phase,analyzes the anatomical-electrical-clinical relationship of the seizure phase,locates and defines the possible epileptogenic zone,and simultaneously stimulates all electrode contacts placed on the electrode to assist in locating the functional zone.Finally,the scope of the epileptogenic focus that the surgery needs to remove is clearly defined.After more than 2 episodes were detected,the electrodes were removed under local anesthesia and epileptogenic tumor resection was performed.Routine symptomatic supportive treatment was performed after surgery,and antiepileptic drugs were continued to be used.They were reviewed and followed up after discharge.Results:(1)Combined with the patient’s clinical symptoms and impact of information,In 12 patients undergoing stereotactic brain deep electrode placement,eleven patients(91.7%)were able to locate the epileptogenic zone and the epileptic network precisely.One episode(8.3%)had no epilepsy during the EEG monitoring period,discharge due to family members,failed to pinpoint the epileptogenic zone.(2)According to the Engel surgical effect grading effect evaluation of 11 cases of surgical treatment,after 3 to 27 months of follow-up,7(63.6%)patientsas Engel’s classⅠ;2(18.2%)patients as Engel’s classⅡ;1(9.1%)patients as Engel’s classⅢ;1(9.1%)patients as Engel’s classⅣ total effective in 10 cases,total effective rate 90.9%.(3)A total of 96 electrodes were implanted in 12 patients undergoing SEEG implantation.One of the electrodes was displaced,resulting in a small amount of intracranial hemorrhage.The incidence of implanted electrode bleeding was 1.04%,one patient had postoperative visual field defect and one patient had IV force of left upper limb.Conclusions:Stereotactic brain deep electrode placement with EEG monitoring can improve the accuracy of epileptogenic localization and the effect of postoperative epilepsy control in patients with refractory traumatic epilepsy and reduce postoperative complications in patients with drug-refractory traumatic epilepsy Surgical treatment helps.Stereotactic brain deep electrode implantation has few complications and is a safe and effective invasive assessment technique. |
