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不同年龄段儿童机器人辅助立体定向脑电图的安全性、准确性和有效性

Safety, Accuracy, and Efficacy of Robot-Assisted Stereo Electroencephalography in Children of Different Ages.

作者信息

Lu Rongrong, Wang Min, Zhang Yi, Li Hao, Zhou Yuanfeng, Wang Yi, Zhao Rui

机构信息

Department of Neurosurgery, Children's Hospital of Fudan University, National Children's Medical Center (Shanghai), Shanghai, People's Republic of China.

Department of Neurology, Children's Hospital of Fudan University, National Children's Medical Center (Shanghai), Shanghai, People's Republic of China.

出版信息

Neurosurgery. 2024 Feb 1;95(1):137-45. doi: 10.1227/neu.0000000000002853.


DOI:10.1227/neu.0000000000002853
PMID:38299855
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11155594/
Abstract

BACKGROUND AND OBJECTIVES: Aimed to investigate the safety, accuracy, and efficacy of stereo electroencephalography (SEEG) in children of various ages, with particular emphasis on those younger than 3 years. There is limited guidance regarding whether SEEG can conducted on very young children. METHODS: This retrospective study was conducted between July 2018 and August 2022. It involved 88 patients who underwent 99 robot-assisted SEEG procedures at our center. The patients were categorized into 3 groups based on their age at the time of the robot-assisted SEEG procedures: group 1 (3 years and younger, n = 28), group 2 (age 3-6 years, n = 27), and group 3 (older than 6 years, n = 44). Clinical data, SEEG demographics, complications, and seizure outcomes were analyzed. RESULTS: A total of 675 electrodes were implanted, with an average of 6.82 ± 3.47 (2.00-16.00) electrodes per patient (P = .052). The average target point error for the 675 electrodes was 1.93 ± 1.11 mm, and the average entry point error was 1.30 ± 0.97 mm (P = .536 and P = .549, respectively). The overall percentage of complications was 6.06% (P = .879). No severe or long-term neurologic impairment was observed. Of the total 99 procedures included in this study, 78 were admitted for epilepsy surgery for the first time, while 9 patients were treated twice and 1 patient was treated 3 times. There were 21 radiofrequency thermocoagulation and 78 second-stage resective procedures performed after SEEG. There was no statistically significant difference in Engel class I outcomes among the patients who underwent SEEG in the 3 age groups (P = .621). CONCLUSION: Robot-assisted SEEG were demonstrated to be safe, accurate, and efficient across different age groups of children. This technique is suitable for children younger than 3 years who have indications for SEEG placement.

摘要

背景与目的:旨在研究立体定向脑电图(SEEG)在不同年龄段儿童中的安全性、准确性和有效性,尤其关注3岁以下儿童。关于能否对非常年幼的儿童进行SEEG检查,目前指导意见有限。 方法:本回顾性研究于2018年7月至2022年8月进行。研究纳入了在我们中心接受99例机器人辅助SEEG手术的88例患者。根据机器人辅助SEEG手术时的年龄,将患者分为3组:第1组(3岁及以下,n = 28),第2组(3至6岁,n = 27),第3组(6岁以上,n = 44)。分析临床数据、SEEG人口统计学、并发症和癫痫发作结局。 结果:共植入675根电极,平均每位患者植入6.82±3.47(2.00 - 16.00)根电极(P = .052)。675根电极的平均靶点误差为1.93±1.11 mm,平均入点误差为1.30±0.97 mm(分别为P = .536和P = .549)。并发症的总体发生率为6.06%(P = .879)。未观察到严重或长期的神经功能损害。本研究纳入的99例手术中,78例首次因癫痫手术入院,9例接受了二次治疗,1例接受了三次治疗。SEEG术后进行了21例射频热凝和78例二期切除手术。3个年龄组接受SEEG检查的患者在恩格尔I级结局方面无统计学显著差异(P = .621)。 结论:机器人辅助SEEG在不同年龄组的儿童中被证明是安全、准确和有效的。该技术适用于有SEEG植入指征的3岁以下儿童。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9208/11155594/eeb48e1eb461/neu-95-137-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9208/11155594/f2bdac2c023d/neu-95-137-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9208/11155594/eeb48e1eb461/neu-95-137-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9208/11155594/f2bdac2c023d/neu-95-137-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9208/11155594/eeb48e1eb461/neu-95-137-g002.jpg

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引用本文的文献

[1]
Diagnostic accuracy of T2-hypointensity in determining the epileptogenic lesion on unmyelinated brain MRI in infants with tuberous sclerosis complex (TSC).

Brain Commun. 2025-6-26

[2]
Stereoelectroencephalography for drug resistant epilepsy: precision and complications in stepwise improvement of frameless implantation.

Acta Neurochir (Wien). 2025-3-17

[3]
Applications and Predictors of Outcomes Following Stereo-Electroencephalography in Pediatric Patients With Drug-Resistant Epilepsy.

CNS Neurosci Ther. 2025-3

[4]
Advancements in Surgical Therapies for Drug-Resistant Epilepsy: A Paradigm Shift towards Precision Care.

Neurol Ther. 2025-4

本文引用的文献

[1]
Frameless robot-assisted stereoelectroencephalography-guided radiofrequency: methodology, results, complications and stereotactic application accuracy in pediatric hypothalamic hamartomas.

Front Neurol. 2023-10-19

[2]
Stereoelectroencephalography before 2 years of age.

Neurosurg Focus. 2022-10

[3]
Variation in pediatric stereoelectroencephalography practice among pediatric neurosurgeons in the United States: survey results.

J Neurosurg Pediatr. 2021-6-18

[4]
Hemorrhage Rates After Implantation and Explantation of Stereotactic Electroencephalography: Reevaluating Patients' Risk.

World Neurosurg. 2021-7

[5]
Optimized SEEG-guided radiofrequency thermocoagulation in the treatment of pediatric hypothalamic hamartomas.

Seizure. 2021-3

[6]
Approach Angle Affects Accuracy in Robotic Stereoelectroencephalography Lead Placement.

World Neurosurg. 2019-4-25

[7]
Accuracy of robot-assisted versus optical frameless navigated stereoelectroencephalography electrode placement in children.

J Neurosurg Pediatr. 2019-3-1

[8]
Invasive evaluation in children (SEEG vs subdural grids).

Seizure. 2020-4

[9]
Electrode placement accuracy in robot-assisted epilepsy surgery: A comparison of different referencing techniques including frame-based CT versus facial laser scan based on CT or MRI.

Epilepsy Behav. 2018-11-27

[10]
Is the use of Stereotactic Electroencephalography Safe and Effective in Children? A Meta-Analysis of the use of Stereotactic Electroencephalography in Comparison to Subdural Grids for Invasive Epilepsy Monitoring in Pediatric Subjects.

Neurosurgery. 2019-6-1

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