PDF(Pubmed)
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.
摘要：
多室周围结节性异位（PVNHs）患者的耐药性癫痫（DRE）的外科治疗具有挑战性。在这些复杂的癫痫网络中识别癫痫发作的位置是困难的，和开放切除术有损伤周围功能性白质束的风险，如视神经辐射（ORs）。作者演示了患有DRE和多个PVNH的患者的纤维束造影辅助激光消融单个结节。手术后,视野完好无损,突出或气管重建的好处。术后12个月，病人仍然没有癫痫发作，提示在精心选择的病例中，在复杂网络中靶向单一异位症的潜在功效。视频可以在这里找到：https://stream。cadmore.媒体/r10.3171/2024.4。FOCVID2417.
