Sami Obaid, Albert Guillemette, Samuel Lapalme-Remis, Joseph Yuan-Mou Yang, Alexander G Weil, Alain Bouthillier
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引用次数: 0
Abstract
Surgical management of drug-resistant epilepsy (DRE) in patients with multiple periventricular nodular heterotopias (PVNHs) is challenging. Identifying the location of seizure onset within these complex epileptic networks is difficult, and open resection carries risks of injury to surrounding functional white matter tracts such as optic radiations (ORs). The authors demonstrate tractography-assisted laser ablation of a single nodule in a patient with DRE and multiple PVNHs. Following surgery, visual fields were intact, highlighting the benefits of OR tractographic reconstruction. At 12 months postoperatively, the patient remained seizure free, suggesting the potential efficacy of targeting a single heterotopia within complex networks in well-selected cases. The video can be found here: https://stream.cadmore.media/r10.3171/2024.4.FOCVID2417.
对患有多发性脑室周围结节性异位灶（PVNHs）的耐药性癫痫（DRE）患者进行手术治疗具有挑战性。在这些复杂的癫痫网络中确定癫痫发作的位置非常困难，而且开放性切除术有可能损伤周围的功能性白质束，如视神经放射（OR）。作者展示了在束成像辅助下激光消融一个单发结节的病例，该患者患有 DRE 和多发性 PVNH。术后，患者的视野完好无损，凸显了视神经放射束重建的优势。术后12个月，患者仍未出现癫痫发作，这表明，在经过精心筛选的病例中，针对复杂网络中的单个异灶进行治疗具有潜在疗效。视频请点击：https://stream.cadmore.media/r10.3171/2024.4.FOCVID2417。
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