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轨道前额:内脑电图和手术方面

Adeel Ilyas^1,2,3,4, Ai Sumida^1,2,5, Pavel S Pichardo-Rojas^1,2

¹Vivian L. Smith Department of Neurosurgery, McGovern Medical School at UT Health Houston, Houston, Texas, U.S.A.

Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society

|November 4, 2025

概括

轨道前 (OFE) 的手术治疗由于症状变化而具有挑战性. 然而,切除术,包括涉及额外大脑区域的切除术,提供了与其他新皮层的无发作率相比较的最低衰退率.

科学领域:

神经外科神经外科
发病学 (Epileptology) 是一个专业的学科.
临床神经学临床神经学

背景情况:

轨道前额 (OFE) 存在诊断上的挑战,因为它具有多种类型和非特异性的EEG模式.
关于OFE手术管理和结果的系统研究是有限的.
20年的外科经验为评估治疗策略提供了基础.

研究的目的:

审查关于OFE外科手术管理的当前文献.
讨论内EEG,微手术技术以及OFE的结果.
基于对24名OFE患者的20年经验,分析手术结果.

主要方法:

在20年内对24名OFE患者进行手术的回顾性评估.
将患者分为纯轨道前端切除术 (OF-focal) 和额外切除术 (OF-plus) 的患者.
临床特征,手术延长和结局的分析 (Engel I-II).

主要成果:

在OF-焦点和OF-plus组之间,年龄,持续时间或MRI病变没有显著差异.
在这两组中,没有光环的高率,普遍的强力克隆性发作和夜间发作.
在50%的OF-焦点患者和57%的OF-plus患者中实现了持久的控制 (Engel I-II).
在36%的非损伤病例中,抓住自由,其中75%经历了OF-plus切除.
皮层发育的形是最常见的病因 (58%).

结论:

对OFE的手术切除产生了与其他新皮层相美的无率.
在OFE中,手术干预可以在最小的认知或功能障碍下安全地进行.
在非损伤病例中,OF-plus切除可能会提供更好的结果.

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