ABSTRACT
Objective To observe the effects of stereotactic implanting depth electrode into the hippocampus on monitoring mesial temporal lobe epilepsy. Methods Thirteen patients with pharmacoresistant epilepsy were included in the present study.The epilcptogenic zone might be located in the hippocampus based on the symptoms and MRI data.Eight-contact depth electrode was implanted into the patients' hippocampus by stereotactic procedures to record the electroencephalogram(EEG).The duration of monitoring lasted for 24-72 hours or more,so as to be sure if the epileptogenic zone was located in the hippocampus,and to provide evidences for surgical resection of epileptic focus.Results Thirteen patients with mesial temporal lobe epilepsy underwent video electroencephalogram monitoring for 72 hours.Twentynine epileptic seizures in 7 patients were detected.Ictal EEG changes manifested as paroxysmal slow wave or spike and slow waves on the background.The epileptiform discharges started from some electrode points,and then propagated to others or the contralateral electrode. After 1-2 seconds of delay,high amplitude slow waves with the frequency of 3-4 Hz were observed on the ipsilateral scalp EEG. Clinical epileptic seizures were not detected in 6 patients during monitoring,depth electrode showed paroxysmal focal high amplitude slow wave or spike and sharp waves,scalp EEG did not find abnormality.Six of thirteen patients received surgical resection of epileptic foci,the outcome during follow-up of 3-8 months was satisfactory.Conclusions To record hippocampal EEG in patients with intractable epilepsy by stereotactic implanting depth electrode into the hippocampus might be a safe and reliable method.It might provide strong evidences for the diagnosis of patients with mesial temporal lobe epilepsy,and for the location of epilcptogenic zone.
ABSTRACT
Objective To observe the therapeutic effect of minimally invasive evacuation of intracerebral hematoma in dog model of cerebral hemorrhage by using Purdy score, serum levels of neuron-specific-enolase (NSE) and numbers of perihematomal apoptotic cells. Method Twenty dogs were selected to prepoxe the model of cerebral hemorrhage, and they were randomly divided( random number) into minimally invasive treatment group and control group. Minimally invasive procedures were performed to evacuate the hematoma in minimally invasive treatment group in 6 hours after the models were established. The dogs of control group only received medical treatment. Purdy score and serum levels of neuron-specific-enolase were determined on 1,3,5,7 days after the evacuation of the hemotoma and apoptotic cells were counted after the dogs were sacrificed at 7 days after operation. All the results were compared with control group. Purdy score and serum levels of neuron-specific-enolase were compaired with variance analysis of repeated measurement design and apoptotic cells was compared with variance analysis of factorial design,the difference of the two groups showed with q test. P <0.01 showed the difference was significant. Results The Purdy scores in minimally invasive treatment group were 6.3 ± 1.702, 5.8 ± 1. 685,4.2 ± 1.762 and 4.1 ± 1.875 on 1,3,5 and 7 day after evacuation of the hematoma, significant difference was observed as compared with the control group(8.9 ± 1.632, 8.6± 1.342, 7.8±1.335, 7.9±1.468, P <0.01).The serum levels of neuron-specific-enolase were 0.632 ± 0.077, 0.721±0.771, 0.549±0.124 and 0.430 ±0.136 respectively in minimally invasive treatment group, while in the control group were 0.934 ± 0. 064, 0. 997 ±0.075, 0.986 ± 0.042, 0.874 ± 0.165, significant differences in serum levels of neuron-specific-enolase were found between the two groups(P < 0.01). The perihematomal apoptotic cells in minimally invasive treatment group(37.4 cells) was decreased significantly as compared with the control group(88.6 cells), with P < 0.01.Conclusions Minimally invasive procedures for evacuation of intracerbral hematoma might significantly reduce the neurological deficit score and decrease the serum neuron-specific enolase levels and numbers of apeptotic neurons.