Comprehensive Epilepsy Center, Department of Neurology, Yale University, New Haven, CT, United States of America; Division of Neurology, University of British Columbia, Vancouver, British Columbia, Canada.
Comprehensive Epilepsy Center, Department of Neurology, Yale University, New Haven, CT, United States of America.
Epilepsy Behav. 2020 Oct;111:107231. doi: 10.1016/j.yebeh.2020.107231. Epub 2020 Jun 29.
The term 'implantation effect' is used to describe an immediate and transient improvement in seizure frequency following an intracranial study for seizure onset localization. We conducted a retrospective analysis of 190 consecutive patients undergoing intracranial electroencephalogram (EEG) monitoring, of whom 41 had no subsequent resection/ablation/stimulation; 33 had adequate data and follow-up time available for analysis. Analysis of seizure frequency following an intracranial study showed 36% (12/33) responder rate (>50% seizure reduction) at one year, decreasing and stabilizing at 20% from year 4 onwards. In addition, we describe three patients (9%) who had long term seizure freedom of more than five years following electrode implantation alone, two of whom had thalamic depth electrodes. Electrode implantation perhaps leads to a neuromodulatory effect sufficient enough to disrupt epileptogenic networks. Rarely, this may be significant enough to even result in long term seizure freedom, as seen in our three patients.
“植入效应”一词用于描述颅内癫痫起始定位研究后癫痫发作频率的即刻和短暂改善。我们对 190 例连续接受颅内脑电图 (EEG) 监测的患者进行了回顾性分析，其中 41 例无后续切除/消融/刺激；33 例有足够的数据和随访时间可供分析。颅内研究后癫痫发作频率分析显示，1 年后有 36%（12/33）的应答率（>50%的发作减少），从第 4 年开始逐渐减少并稳定在 20%。此外，我们描述了 3 例（9%）患者在单独植入电极后有超过 5 年的长期无癫痫发作，其中 2 例患者植入了丘脑深部电极。电极植入可能会产生足够的神经调节作用，足以破坏致痫性网络。很少有这种情况足以导致长期无癫痫发作，正如我们的 3 例患者所见。
