Upadhyayula Pavan S, Rennert Robert C, Hoshide Reid, Sattar Shifteh, Gonda David D
Department of Neurosurgery, University of California San Diego, San Diego, California, USA.
Department of Neurosciences, University of California San Diego, San Diego, California, USA.
Stereotact Funct Neurosurg. 2019;97(1):10-17. doi: 10.1159/000496155. Epub 2019 Apr 3.
Nonlesional cingulate gyrus epilepsy is rare, difficult to diagnose, and challenging to treat.
We report the use of ROSA (Medtech Surgical, Inc., New York, NY, USA) robotic assistance for stereotactic EEG (S-EEG) localization and therapeutic thermal laser ablation of a nonlesional cingulate gyrus epileptogenic zone in a 17-year-old female with intractable partial epilepsy.
After an inconclusive exhaustive initial workup, robotic-assisted S-EEG localized the patient's seizure focus to the right cingulate gyrus. Robotic-assisted lesioning of the cingulate gyrus was performed via 5 total ablations with 3 minimally invasive catheters. There were no perioperative complications. The patient was discharged home on postoperative day 2 at her neurologic baseline. She was seizure free for 8 months postoperatively, with a sustained partial response through the 23-month follow-up.
This report expands the technical uses, pathologies, and patient populations being treated via robotic-assisted neurosurgery.
非病灶性扣带回癫痫罕见，诊断困难且治疗具有挑战性。
我们报告了使用ROSA（美国纽约Medtech Surgical公司）机器人辅助立体定向脑电图（S-EEG）定位，并对一名患有难治性部分性癫痫的17岁女性患者的非病灶性扣带回癫痫病灶区进行治疗性热激光消融。
经过全面的初步检查但未得出明确结果后，机器人辅助S-EEG将患者的癫痫发作灶定位至右侧扣带回。通过使用3根微创导管进行5次完全消融，对扣带回进行了机器人辅助损伤。无围手术期并发症。患者术后第２天神经功能恢复至基线水平后出院。术后8个月无癫痫发作，在23个月的随访期内持续有部分缓解。
本报告扩展了机器人辅助神经外科手术的技术应用范围、治疗的病理类型和患者群体。
