Современные нейрохирургические подходы к терапии структурных эпилепсий

Andrey R. Sitnikov1, Victoria A. Skorobogatova2, Natalia N. Maslova2
1ФГАУ «Лечебно-реабилитационный центр» Минздрава РФ, Москва, Россия; 2ФГБОУ ВО «Смоленский государственный медицинский университет», Смоленск, Россия

Аннотация


Фармакорезистентная эпилепсия по-прежнему представляет нерешенную проблему современной неврологии. Актуальные нейрохирургические методики позволяют эффективно справиться с ней у ряда пациентов, на протяжении многих лет страдавших медикаментозно некупируемыми приступами. В обзоре рассмотрены современные нейрохирургические подходы в лечении эпилепсии, основные вопросы предоперационной диагностики и показания для нейрохирургического лечения. Представлен клинический случай пациентки, которой была успешно проведена стереотаксическая установка электродов в области передних таламических ядер со значительным клиническим улучшением по результатам динамического наблюдения.

Литература

 

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  4. Berg A.T., Langfitt J., Shinnar S. et al. How long does it take for partial epilepsy to become intractable? Neurology 2003; 60: 186–190. PMID: 12552028.
  5.  Picot M.C., Jaussent A., Neveu D. et al. Cost-effectiveness analysis of epilepsy surgery in a controlled cohort of adult patients with intractable partial epilepsy : a 5-year follow-up study. Epilepsia 2016; 57: 1669–1679. DOI: 10.1111/epi.13492. PMID: 27595433.
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  7. Choi H., Carlino R., Heiman G. et al. Evaluation of duration of epilepsy prior to temporal lobe epilepsy surgery during the past two decades. Epilepsy Res 2009; 86: 224–227. DOI: 10.1016/j.eplepsyres.2009.05.014. PMID: 19581072.
  8. Haneef Z., Stern J., Dewar S., Engel J.Jr. Referral pattern for epilepsy surgery after evidence-based recommendations: a retrospective study. Neurology 2010 ;75: 699–704. DOI: 10.1212/WNL.0b013e3181eee457. PMID: 20733145.
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  20. Harward S.C., Chen W.C., Rolston J.D. et al. Seizure outcomes in occipital lobe and posterior quadrant epilepsy surgery: a systematic review and meta-analysis. Neurosurgery 2018; 82: 350–358. DOI: 10.1093/neuros/nyx158. PMID: 28419330.
  21. Graham D., Tisdall M.M., Gill D. Corpus callosotomy outcomes in pediatric patients: a systematic review Epilepsia 2016; 57: 1053–1068. DOI: 10.1111/epi.13408. PMID: 27237542.
  22. Paglioli E., Martins W.A., Azambuja N. et al. Selective posterior callosotomy for drop attacks: a new approach sparing prefrontal connectivity. Neurology 2016 ;87: 1968–1974. DOI: 10.1212/WNL.0000000000003307. PMID: 27733569.
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  24. Usami K., Kawai K., Koga T. et al. Delayed complication after Gamma Knife surgery for mesial temporal lobe epilepsy. J Neurosurg 2012; 116: 1221–1225. DOI: 10.3171/2012.2.JNS111296. PMID: 22443500.
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  35. Gill S.J., Lukmanji S., Fiest K.M. et al. Depression screening tools in persons with epilepsy : a systematic review of validated tools. Epilepsia 2017; 58: 695–705. DOI: 10.1111/epi.13651. PMID: 28064446.
  36. Helmstaedter C., Van Roost D., Clusmann H. et al. Collateral brain damage, a potential source of cognitive impairment after selective surgery for control of mesial temporal lobe epilepsy. J Neurol Neurosurg Psychiatry 2004; 75: 323–326. PMID: 14742620.
  37. Sidhu M.K., Stretton J., Winston G.P. et al. Memory fMRI predicts verbal memory decline after anterior temporal lobe resection. Neurology 2015; 84: 1512–1519. DOI: 10.1212/WNL.0000000000001461. PMID: 25770199.
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  39. Hoppe C., Helmstaedter C. Sensitive and specific neuropsychological assessments of the behavioral effects of epilepsy and its treatment are essential. Epilepsia 2010; 51: 2365–2366. PMID : 21192325.

Ключевые слова

эпилепсия; фармакорезистентность; глубокая стимуляция мозга; передние таламические ядра; ответная нейростимуляция

Полный текст:

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Литература

Engel J.Jr. What can we do for people with drug-resistant epilepsy. The 2016 Wartenberg Lecture. Neurology 2016; 87: 2483–2489. DOI: 10.1212/WNL.0000000000003407. PMID: 27920283.

Engel J.Jr., Wiebe S., French J. et al. Practice parameter: temporal lobe and localized neocortical resections for epilepsy: report of the Quality Standards Subcommittee of the American Academy of Neurology, in association with the American Epilepsy Society and the American Association of Neurology. Neurology 2003; 60: 538–547. PMID: 12601090.

Engel J.Jr, McDermott M.P., Wiebe S. et al. Early surgical therapy for drug-resistant temporal lobe epilepsy. JAMA 2012; 307: 922–930. DOI: 10.1001/jama.2012.220. PMID: 22396514.

Berg A.T., Langfitt J., Shinnar S. et al. How long does it take for partial epilepsy to become intractable? Neurology 2003; 60: 186–190. PMID: 12552028.

Picot M.C., Jaussent A., Neveu D. et al. Cost-effectiveness analysis of epilepsy surgery in a controlled cohort of adult patients with intractable partial epilepsy : a 5-year follow-up study. Epilepsia 2016; 57: 1669–1679. DOI: 10.1111/epi.13492. PMID: 27595433.

Englot D.J., Ouyang D., Garcia P.A. et al. Epilepsy surgery trends in the United States, 1990–2008. Neurology 2012 ;78 :1200–1206. DOI: 10.1212/WNL.0b013e318250d7ea. PMID: 22442428.

Choi H., Carlino R., Heiman G. et al. Evaluation of duration of epilepsy prior to temporal lobe epilepsy surgery during the past two decades. Epilepsy Res 2009; 86: 224–227. DOI: 10.1016/j.eplepsyres.2009.05.014. PMID: 19581072.

Haneef Z., Stern J., Dewar S., Engel J.Jr. Referral pattern for epilepsy surgery after evidence-based recommendations: a retrospective study. Neurology 2010 ;75: 699–704. DOI: 10.1212/WNL.0b013e3181eee457. PMID: 20733145.

Bell G.S., de Tisi J., Gonzalez-Fraile J.C. et al. Factors affecting seizure outcome after epilepsy surgery: an observational series. J Neurol Neurosurg Psychiatry 2017;88 : 933–940. DOI: 10.1136/jnnp-2017-316211. PMID: 28870986.

Woermann F.G., Barker G.J., Birnie K.D. et al. Regional changes in hippocampal T2 relaxation and volume: a quantitative magnetic resonance imaging study of hippocampal sclerosis. J Neurol Neurosurg Psychiatry 1998; 65: 656–664. PMID : 9810933.

Friedman E. Epilepsy imaging in adults: getting it right. AJR Am J Roentgenol 2014; 203: 1093–1103. DOI: 10.2214/AJR.13.12035. PMID: 25341150.

Bauer P.R., Reitsma J.B., Houweling B.M. et al. Can fMRI safely replace the Wada test for preoperative assessment of language lateralisation? A meta-analysis and systematic review. J Neurol Neurosurg Psychiatry 2014; 85: 581–588. DOI: 10.1136/jnnp-2013-305659. PMID: 23986313.

Paldino M.J., Yang E., Jones J.Y. et al. Comparison of the diagnostic accuracy of PET/MRI to PET/CT-acquired FDG brain exams for seizure focus detection: a prospective study. Pediatr Radiol 2017; 47: 1500–1507. DOI: 10.1007/s00247-017-3888-8. PMID: 28512714.

Duncan J.S., Hamani C. Stimulating the brain for epilepsy. Neurology 2015; 84: 768–769. DOI: 10.1212/WNL.0000000000001297. PMID: 25616484.

Helmstaedter C., Richter S., Röske S. et al. Differential effects of temporal pole resection with amygdalohippocampectomy versus selective amygdalohippocampectomy on material-specific memory in patients with mesial temporal lobe epilepsy. Epilepsia 2008; 49:88–97. DOI: 10.1111/j.1528-1167.2007.01386.x. PMID: 17941848.

Englot D.J., Wang D.D., Rolston J.D. et al. Rates and predictors of long-term seizure freedom after frontal lobe epilepsy surgery: a systematic review and meta-analysis. J Neurosurg 2012; 116: 1042–1048. DOI: 10.3171/2012.1.JNS111620. PMID: 22304450.

Laoprasert P., Ojemann J.G., Handler M.H. Insular epilepsy surgery. Epilepsia 2017 ; 58(suppl 1): 35–45. DOI: 10.1111/epi.13682. PMID: 28386920.

Asadollahi M., Sperling M.R., Rabiei A.H., Asadi-Pooya A.A. Drug-resistant parietal lobe epilepsy: clinical manifestations and surgery outcome. Epileptic Disord 2017; 19: 35–39. DOI: 10.1684/epd.2017.0893. PMID: 28256447.

Salanova V., Andermann F., Olivier A. et al. Occipital lobe epilepsy: electroclinical manifestations, electrocorticography, cortical stimulation and outcome in 42 patients treated between 1930 and 1991. Surgery of occipital lobe epilepsy. Brain 1992; 115(Pt 6): 1655–1680. PMID : 1486456.

Harward S.C., Chen W.C., Rolston J.D. et al. Seizure outcomes in occipital lobe and posterior quadrant epilepsy surgery: a systematic review and meta-analysis. Neurosurgery 2018; 82: 350–358. DOI: 10.1093/neuros/nyx158. PMID: 28419330.

Graham D., Tisdall M.M., Gill D. Corpus callosotomy outcomes in pediatric patients: a systematic review Epilepsia 2016; 57: 1053–1068. DOI: 10.1111/epi.13408. PMID: 27237542.

Paglioli E., Martins W.A., Azambuja N. et al. Selective posterior callosotomy for drop attacks: a new approach sparing prefrontal connectivity. Neurology 2016 ;87: 1968–1974. DOI: 10.1212/WNL.0000000000003307. PMID: 27733569.

Feng E.S., Sui C.B., Wang T.X., Sun G.L. Stereotactic radiosurgery for the treatment of mesial temporal lobe epilepsy. Acta Neurol Scand 2016; 134: 442–451. DOI: 10.1111/ane.12562. PMID: 26846702.

Usami K., Kawai K., Koga T. et al. Delayed complication after Gamma Knife surgery for mesial temporal lobe epilepsy. J Neurosurg 2012; 116: 1221–1225. DOI: 10.3171/2012.2.JNS111296. PMID: 22443500.

Wu C., Boorman D.W., Gorniak R.J. et al. The effects of anatomic variations on stereotactic laser amygdalohippocampectomy and a proposed protocol for trajectory planning. Neurosurgery 2015; 11(suppl 2): 345–347. doi: 10.1227/NEU.0000000000000767. PMID: 25850599.

Vakharia V.N., Sparks R., Kuo L. et al. Automated trajectory planning for laser interstitial thermal therapy in mesial temporal lobe epilepsy. Epilepsia 2018; 59: 814–824. DOI: 10.1111/epi.14034. PMID: 29528488.

Drane D.L., Loring D.W., Voets N.L. et al. Better object recognition and naming outcome with MRI-guided stereotactic laser amygdalohippocampotomy for temporal lobe epilepsy. Epilepsia 2015; 56:101–113. DOI: 10.1111/epi.12860. PMID: 25489630.

Benabid A.L., Koudsie A., Benazzouz A. et al. Deep brain stimulation of the corpus Luysi (subthalamic nucleus) and other targets in Parkinson's disease. Extension to new indications such as dystonia and epilepsy. J Neurol 2001; 248(Suppl 3) : 37–47. PMID: 11697687.

Kerrigan J.F., Litt B., Fisher R.S. et al. Electrical stimulation of the anterior nucleus of the thalamus for the treatment of intractable epilepsy. Epilepsia 2004 ; 45: 346–354. DOI: 10.1111/j.0013-9580.2004.01304.x. PMID: 15030497.

Lehtimäki K., Möttönen T., Järventausta K. et al. Outcome based definition of the anterior thalamic deep brain stimulation target in refractory epilepsy. Brain Stimul 2016 ; 9 : 268-275. DOI: 10.1016/j.brs.2015.09.014. PMID: 26680105.

Sitnikov A.R., Grigoryan Yu.A., Mishnyakova L.P. [Stimulation of anterior thalamic nuclei with inra-operative microelectrode recording for treatment of drug-resistant epilepsy. Russian neurosurgical journal named after professor Polenov 2015 ; 7(4): 64–72. (In Russ.)

Singhal N.S., Numis A.L., Lee M.B. et al. Responsive neuostimulation for treatment of pediatric drug-resistant epilepsy. Epilepsy Behav Case Rep 2018; 10: 21–24. DOI: 10.1016/j.ebcr.2018.02.002. PMID: 30013930.

Morrell M.J., RNS System in Epilepsy Study Group. Responsive cortical stimulation for the treatment of medically intractable partial epilepsy. Neurology 2011; 77: 1295–1304. DOI: 10.1212/WNL.0b013e3182302056. PMID: 21917777.

Bergey G.K., Morrell M.J., Mizrahi E.M. et al. Long-term treatment with responsive brain stimulation in adults with refractory partial seizures. Neurology 2015; 84: 810–817. DOI: 10.1212/WNL.0000000000001280. PMID: 25616485.

Gill S.J., Lukmanji S., Fiest K.M. et al. Depression screening tools in persons with epilepsy : a systematic review of validated tools. Epilepsia 2017; 58: 695–705. DOI: 10.1111/epi.13651. PMID: 28064446.

Helmstaedter C., Van Roost D., Clusmann H. et al. Collateral brain damage, a potential source of cognitive impairment after selective surgery for control of mesial temporal lobe epilepsy. J Neurol Neurosurg Psychiatry 2004; 75: 323–326. PMID: 14742620.

Sidhu M.K., Stretton J., Winston G.P. et al. Memory fMRI predicts verbal memory decline after anterior temporal lobe resection. Neurology 2015; 84: 1512–1519. DOI: 10.1212/WNL.0000000000001461. PMID: 25770199.

Bonelli S.B., Thompson P.J., Yogarajah M. et al. Memory reorganization following anterior temporal lobe resection: a longitudinal functional MRI study. Brain 2013; 136(pt 6): 1889–1900. DOI: 10.1093/brain/awt105. PMID: 23715092.

Hoppe C., Helmstaedter C. Sensitive and specific neuropsychological assessments of the behavioral effects of epilepsy and its treatment are essential. Epilepsia 2010; 51: 2365–2366. PMID : 21192325.




DOI: http://dx.doi.org/10.25692/ACEN.2019.1.8