Epilepsy Center, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
Epilepsy Behav. 2012 Aug;24(4):513-6. doi: 10.1016/j.yebeh.2012.06.009. Epub 2012 Jul 12.
We report a 39-year-old man with bilateral mesial temporal lobe epilepsy. He was implanted with a responsive brain stimulator (RNS System) with two depth electrodes placed in the bimesial temporal structures. After the implantation, his seizure frequency decreased by up to 50%. Electrocorticogram recorded by the RNS device revealed the right-sided predominance of seizure onset. He underwent a right temporal lobectomy, and his seizure significantly improved. After the RNS System was restarted 107 days after the temporal lobectomy, he has been seizure free for more than 1.5 years. However, the implanted device continued to record residual ictal activities at the posterior aspect of the right hippocampus and delivered electrical stimuli to suppress the seizure activities. Our report indicates the importance of electrocorticographic recordings by the RNS System to modify the treatment strategy and the complementary effect of surgical resection and brain stimulation in the treatment of epilepsy.
我们报告了一例 39 岁的双侧颞叶内侧癫痫患者。他接受了反应性脑刺激器（RNS 系统）的植入，两个深部电极放置在双侧颞叶结构内。植入后，他的癫痫发作频率降低了多达 50%。RNS 设备记录的脑电图显示右侧起始的癫痫发作占优势。他接受了右侧颞叶切除术，他的癫痫显著改善。颞叶切除术后 107 天重新启动 RNS 系统后，他已经无癫痫发作超过 1.5 年。然而，植入设备继续记录右侧海马体后部的残留发作活动，并施加电刺激以抑制癫痫发作活动。我们的报告表明，RNS 系统的脑电图记录对于修改治疗策略以及手术切除和脑刺激在癫痫治疗中的互补作用非常重要。
