Park Jun T, Baca Vaca Guadalupe Fernandez, Avery Jennifer, Miller Jonathan P
a Epilepsy Center , Cleveland University Hospitals , Cleveland , Ohio.
b Case Western Reserve University School of Medicine , Cleveland , Ohio.
Neurodiagn J. 2017;57(3):191-210. doi: 10.1080/21646821.2017.1326270.
Uncontrolled seizures in children can contribute to irreversible cognitive impairment and developmental delay, in addition to placing them at risk for sudden unexplained death in epileptic patients (SUDEP). Since its introduction at Saint Ann Hospital in Paris in the 1960s, stereoelectroencephalography (SEEG) is increasingly being utilized at epilepsy centers in the United States as an invasive tool to help localize the seizure focus in drug-resistant focal epilepsy.
Children with symptomatic epilepsy, commonly due to cortical dysplasia and dysembryoplastic neuroepithelial tumor (DNET), may benefit from SEEG investigation. The arrangement of SEEG electrodes is individually tailored based on the suspected location of the epileptogenic zone (EZ). The implanted depth electrodes are used to electrically stimulate the corresponding cortices to obtain information about the topography of eloquent cortex and EZ. Morbidity: Surgical morbidity in these children undergoing SEEG investigation is low, but not negligible. The number of electrodes directly correlates with the risk of intraoperative complication. Thus a risk and benefit analysis needs to be carefully considered for each patient. Neurodiagnostic technology: Both during and after the SEEG electrode implantation, the intraoperative monitoring and EEG technologists play a vital role in the successful monitoring of the patient.
SEEG is an important tool in the process of epilepsy surgery in children with symptomatic epilepsy, commonly due to cortical dysplasia and DNET.
儿童癫痫发作若得不到控制，除了会使其面临癫痫患者不明原因猝死（SUDEP）的风险外，还可能导致不可逆转的认知障碍和发育迟缓。自20世纪60年代在巴黎圣安医院引入以来，立体定向脑电图（SEEG）在美国的癫痫中心越来越多地被用作一种侵入性工具，以帮助定位耐药性局灶性癫痫的癫痫发作病灶。
有症状性癫痫的儿童，常见病因是皮质发育异常和胚胎发育不良性神经上皮肿瘤（DNET），可能从SEEG检查中获益。SEEG电极的布置是根据癫痫ogenic区（EZ）的疑似位置进行个体化定制的。植入的深部电极用于电刺激相应的皮质，以获取有关明确皮质和EZ地形图的信息。发病率：接受SEEG检查的这些儿童的手术发病率较低，但并非可以忽略不计。电极数量与术中并发症风险直接相关。因此，需要为每位患者仔细考虑风险和获益分析。神经诊断技术：在SEEG电极植入期间和之后，术中监测和脑电图技术人员在成功监测患者方面发挥着至关重要的作用。
SEEG是有症状性癫痫儿童（常见病因是皮质发育异常和DNET）癫痫手术过程中的一项重要工具。
