癫痫杂志

癫痫杂志

灰质异位与癫痫发作

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灰质异位在药物难治性癫痫中并非少见,是胚胎发育阶段神经元移行障碍导致的大脑畸形之一,其主要原因有遗传因素(最常见的是 FLNA 基因突变)、肌动蛋白缺乏及母亲在妊娠期接受 X 线或其他外界因素的影响。灰质异位癫痫发作的机制尚不完全了解,据颅内电极尤其是立体定向脑电图(SEEG)研究发现,发作多起源于异位灰质及相关皮质两者,少数起源于异位灰质或大脑皮质。灰质异位的诊断主要依据为在大脑内有与大脑皮质信号一致的结节、团块或与皮质平行的带状异常。对于合并癫痫发作者头皮脑电图意义不大,颅内电极尤其是 SEEG 可以发现发作的起源、异位灰质与大脑皮质的关系,以及异常网络间的联系,所以 SEEG 是必不可少的检测项目。灰质异位合并的癫痫,绝大多数为药物难治性患者,在 SEEG 指导下的外科治疗可以获得非常好的疗效。

关键词: 灰质异位; 癫痫; 磁共振成像; 脑电图; 外科治疗

引用本文: 邓馨, 王薇薇, 吴逊. 灰质异位与癫痫发作. 癫痫杂志, 2018, 4(6): 497-504. doi: 10.7507/2096-0247.20180080 复制

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