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Abstract：
The best results of stereoelectroencephalography (SEEG)-guided radiofrequency thermocoagulation (RF-TC) were observed in epilepsies with more limited lesions, but this procedure is rarely used in a wide range of brain malformation. We report a rare case of polymicrogyria (PMG) combined with drug-resistant startle seizures. Presurgical monitoring was performed using SEEG owing to the large lesion and complexity of PMG. According to the intracranial electrode results, the seizure onset was extensive, with the onset starting earlier in the cingulate sulcus and insular pole than in other sites of the other electrodes. Multi-point and multi-step SEEG-guided RF-TC was used for diffuse lesion and functional protection. RF-TC was first applied to the cingulate sulcus and insular pole, and our patient was rendered free from startle seizures after 2 weeks. Two weeks of observation helped us to observe the efficacy of RF-TC and the changes of SEEG, so as to make the next TC scheme. The patient still had spontaneous seizures after the first treatment. RF-TC was then applied to other sites involved earlier. Finally, the patient reached Engel class IIa for a follow-up period of 1 year. There were no additional startle seizures, and important functional areas were protected.
摘要：
立体脑电图（SEEG）引导的射频热凝（RF-TC）的最佳结果在病变较有限的癫痫中观察到，但是这种方法很少用于广泛的大脑畸形。我们报告了一例罕见的多微病毒（PMG）合并抗药性惊厥发作的病例。由于PMG的大病变和复杂性，使用SEEG进行了术前监测。根据颅内电极结果,癫痫发作广泛，与其他电极的其他部位相比，在扣带沟和岛状极开始的时间更早。多点和多步骤SEEG引导的RF-TC用于弥漫性病变和功能保护。RF-TC首先应用于扣带沟和岛状极，我们的患者在2周后免于惊吓性癫痫发作。两周的观察有助于我们观察RF-TC的疗效和SEEG的变化，从而制定下一个TC方案。患者在第一次治疗后仍有自发性癫痫发作。然后将RF-TC应用于较早涉及的其他站点。最后,患者达到EngelIIa级,随访1年.没有额外的惊吓发作，重要功能区得到保护。
