术中立体定向脑电图（SEEG）和氟代脱氧葡萄糖正电子发射断层扫描（FDG-PET）定制的颞叶切除术（iSP-TR）用于耐药性内侧颞叶癫痫的组织穿刺手术治疗：我们的做法。
The intraoperative SEEG and FDG-PET tailored temporal lobe resection (iSP-TR) for the tissue-spearing surgical treatment of drug-resistant mesial temporal lobe epilepsy: how we do it.
作者信息
Battista Francesca, Carrai Riccardo, Grippo Antonello, Della Puppa Alessandro
机构信息
Department of Neurosurgery, Careggi University Hospital, Florence, Italy.
Neurophysiopathology Unit, Neuro-Muscular-Skeletal Department, Careggi Hospital, University of Florence, Florence, Italy.
出版信息
Acta Neurochir (Wien). 2025 Mar 19;167(1):82. doi: 10.1007/s00701-025-06491-x.
BACKGROUND
For drug-resistant mesial temporal lobe epilepsy (MTLE), surgery is recommended. There is no evidence of a seizure outcome advantage of temporal lobectomy over other strategies despite the high risks of this surgical procedure.
METHODS
We describe a Temporal Resection guided by intraoperative stereo-electroencephalography (iSEEG) and the FluoroDeoxyGlucose PET (FDG PET) (iSP-TR) to treat lesional MTLE. We avoided functional cortical areas using navigated Transcranial Magnetic Stimulation (nTMS).
CONCLUSION
iSP-TR allows for a spare brain parenchyma compared to temporal lobectomy without compromising seizure outcomes.
背景
对于耐药性内侧颞叶癫痫（MTLE），建议进行手术治疗。尽管该手术风险高，但尚无证据表明颞叶切除术在癫痫发作结局方面优于其他治疗策略。
方法
我们描述了一种在术中立体脑电图（iSEEG）和氟脱氧葡萄糖正电子发射断层扫描（FDG PET）引导下进行颞叶切除术（iSP-TR）来治疗有病灶的MTLE。我们使用导航经颅磁刺激（nTMS）避开功能皮质区域。
结论
与颞叶切除术相比，iSP-TR在不影响癫痫发作结局的情况下可保留脑实质。
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