摘要
目的本研究基于腹型癫痫的临床特征,通过整合视频脑电图(VEEG)、磁共振(MRI)、正电子发射断层扫描(PET-CT)、立体定向颅内电极(SEEG)等诊断技术,综合建立个体化腹型癫痫诊疗方案,系统分析其临床特征及手术治疗效果。方法回顾性分析2016年4月~2024年7月就诊的11例腹型癫痫患者,分析患者的临床特征、VEEG、MRI、PET-CT、SEEG等资料,评估诊断准确性及手术效果。结果11例患者年龄范围3~25岁,平均年龄11.5±7.8岁,其中儿童(≤12岁)8例,成人3例,发作形式均以发作性腹痛起病,伴自主神经症状(5例)或运动症状(5例)或自动症(3例)。MRI显示颞叶结构异常患者7例,其中5例结构异常位置与PET-CT代谢异常位置重叠,头皮脑电图(6例)与SEEG(3例)显示颞叶发作起源。11例患者中,1例未接受手术治疗,10例采用病灶切除治疗患者,其中9例EngelⅠ级,1例EngelⅢ级,总有效率90%。结论腹型癫痫的致痫网络主要涉及颞叶-边缘系统,多种技术结合可显著提高诊断准确性,手术治疗对难治性癫痫患者具有显著疗效,但需重点关注术后神经系统及认知功能损伤的评估与干预。
Objective This study aimed to develop individualized diagnostic and therapeutic strategies for abdominal epilepsy by integrating its clinical characteristics with multimodal techniques including video electroencephalography(VEEG),magnetic resonance imaging(MRI),positron emission tomography-computed tomography(PET-CT),and stereotactic electroencephalography(SEEG),and to systematically evaluate the clinical features and surgical outcomes.Methods We conducted a retrospective review of 11 patients diagnosed with abdominal epilepsy between April 2016 and July 2024.Clinical profiles and findings from VEEG,MRI,PET-CT,and SEEG were analyzed to assess diagnostic precision and surgical efficacy.Results The cohort consisted of 11 patients aged 3 to 25 years(mean age 11.5±7.8 years),including 8 children(≤12 years)and 3 adults.All patients(100%)presented with paroxysmal abdominal pain as the initial manifestation,accompanied by autonomic symptoms(5 cases),motor symptoms(5 cases),or automatisms(3 cases).MRI revealed temporal lobe structural abnormalities in 7 patients,with colocalization of structural and PET-CT metabolic abnormalities observed in 5 cases.Both scalp EEG(6 cases)and SEEG(3 cases)indicated a temporal lobe seizure origin.Among the 11 patients,10 underwent lesion resection,resulting in Engel class I outcome in 9 cases and Engel class III in 1 case,yielding an overall effectiveness rate of 90%.One patient did not receive surgical intervention.Conclusion The epileptogenic network in abdominal epilepsy primarily involves the temporal-limbic system.Multimodal evaluation significantly enhances diagnostic accuracy,and surgical intervention demonstrates substantial efficacy for drug-resistant cases.Postoperative assessment and management of neurological and cognitive functions warrant focused attention.
作者
郎永翠
胡月
刘垚岭
张宁宁
李文倩
张光明
Lang Yongcui;Hu Yu;Liu Yaoling;Zhang Ningning;Li Wenqian;Zhang Guangming(Epilepsy,Center,Neurosurgery Department,Aviation General Hospital,Beijing,100012,China)
出处
《立体定向和功能性神经外科杂志》
2025年第5期278-283,共6页
Chinese Journal of Stereotactic and Functional Neurosurgery
基金
科技创新2030-“脑科学与类脑研究”(编号:2021ZD0200200)。
关键词
腹型癫痫
诊断
颞叶-边缘网络
立体定向颅内脑电图
手术疗效
Abdominal Epilepsy
Diagnosis
Temporal-limbic Network
Stereotactic electroencephalography(SEEG)
Surgical outcome
