反应性"刷牙":在用fMRI辅助的焦切除后,发作没有发作
Michael Ginevra1, John Archer1,2, Kristian Bulluss3,4
1Department of Neurology, Austin Health, Melbourne, Victoria, Australia.
概括
这项研究呈现了一种罕见的牙刷,一种由口腔刺激引发的反射. 通过先进的成像和微创的射频热凝疗,在患有抗药性焦点运动的患者中成功实现了长期的自由.
科学领域:
- 神经学 神经学
- 神经外科 神经外科
- 发病学 (Epileptology) 是一个专业的学科.
背景情况:
- 反射性的特征是由于特定刺激引发的发作.
- 牙刷是一种罕见的亚型,经常出现焦点运动发作.
- 耐药性对患者的治疗和生活质量构成重大挑战.
研究的目的:
- 描述一种因刷牙引发的耐药焦点运动的独特案例.
- 为了说明ictal功能性MRI (fMRI) 在引导立体电脑图 (sEEG) 精确位定位方面的实用性.
- 报告微创射频 (RF) 热凝固治疗的成功长期结果.
主要方法:
- 在牙刷过程中使用了头皮伊克塔尔EEG和基于任务的fMRI来定位发作.
- 立体电脑图 (sEEG) 证实了在左侧中心皮层发作的开始.
- 进行了射频 (RF) 热凝,以确定发作焦点为目标.
主要成果:
- 在反射发作和刷牙期间,fMRI显示左下围心皮层的焦点激活.
- sEEG证实了与fMRI发现相符的反复发生的阴茎尖刺.
- 患者在RF热凝后超过3年实现了完全的发作自由.
结论:
- 在罕见的综合征中,Ictal fMRI是准确准sEEG植入的一个有价值的工具.
- 最少侵入性射频热凝疗可以是药物耐药焦点的有效治疗方法.
- 这一案例突出了成功的多学科方法来管理具有挑战性的反射性病例.
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