立体声电Encephalo-造影（SEEG）随着医学难治性癫痫的术前评估机器人辅助：技术说明
Summary
Stereo-electroencephalography (SEEG) aids in localization of epileptogenic zones, however, remains relatively underutilized in the United States. The goal of this abstract is to provide a brief introduction to the technique of SEEG and further a detailed technique of using robotic assistance in the placement of SEEG electrodes.
Abstract
SEEG是通过三维录音用于癫痫发作的准确，微创记录的方法和技术。在谁是认为合适的候选人有创记录癫痫病人，监察决定硬膜下格栅与SEEG之间进行。癫痫神经监测侵入患者复杂，难治性癫痫的追求。中创监测的目标是提供切除手术以使癫痫发作自由的希望。 SEEG的优势，包括进入深皮质结构，本地化的致痫区（EZ）时，硬膜下网格都未能做到这一点，并在患者的非皮损额外的时空性癫痫的能力。在这个手稿中，我们提出了SEEG的简要历史回顾和我们的下机器人立体定向无框体验报告。 SEEG插入当务之急步骤规划电极轨迹。为了最有效地记录通过SEEG轨迹发作活动应该基于对那里的癫痫发作起源推测的致痫灶（EZ）假设规划。在EZ假说是基于一个标准的术前后处理包括视频脑电图监测，MRI（磁共振成像），PET（正电子发射断层摄影术），发作SPECT（单光子发射计算机断层扫描），和神经心理学评估。使用EZ嫌疑，SEEG电极可以放在最小侵入性的同时保持准确度和精密度。临床结果表明本地化EZ在难以定位癫痫患者78％的能力。1
Introduction
In medically refractory epilepsy there are many non-invasive pre-surgical tools (scalp EEG., magnetic resonance imaging (MRI), functional MRI, single photon emission computed tomography, positron emission topography, and magnetoencephalography). If these non-invasive evaluations fail to sufficiently localize or define the epileptic zone (EZ) then invasive recording may be indicated. Currently, subdural grids or Stereo-electro-encephalo-graphy (SEEG) are the two most prevalent methods of invasive monitoring. SEEG was originally developed in France in the 1950’s by Jean Talairach and Jean Bancaud; recently it has mostly been used for invasive monitoring of refractory epilepsy patients in France.2-4 SEEG is the consists of stereotactically inserting intracerebral electrodes into the brain parenchyma to record brain electrical activity for an extended period of time. With the intracerebral electrical recordings many patients are able to have their EZ defined to allow for surgical resection.
Despite this long history of success SEEG remains relatively rarely used for invasive recording in America. However, SEEG does offer several significant advantages; SEEG allows for 1) recording of deep structures, 2) bihemispheric recordings, 3) another recording option if subdural grids failed, and 4) mapping of epileptic networks in three dimensions, mainly in patients where non-lesional extra-temporal epilepsy is suspected.5-7 All of these benefits are achieved without requiring a large craniotomy. A recent technologic advance in SEEG surgery is the used of robotic guidance. This sophisticated development allows for improved operative times but safer and more accurate surgical implantation of electrodes.Recently published literature reviews the results of using two different techniques for SEEG insertion; a more traditional method utilizing stereotactic frames and a newer technique using robotic assistante for SEEG insertion.1, 8,15 the results were similarly successful with each method.
With the advent of improved robotic assistance, the SEEG insertion technique has resulted in improved operative times. The robotic system is classified as a supervisory controlled system which means the surgeon plans the operation off line and implicitly specifies the motion the robot must follow to perform the operation.9 The robotic assist results in expedient transitions from one trajectory to the next for the placement of each intracranial electrode.
Protocol
Representative Results
Discussion
在这里，提出利用机器人立体定向援助SEEG插入技术。同时采用基于帧的立体定位等方法最初描述SEEG，机器人辅助SEEG不仅提供类似的安全性，更高的精度和效率。在个案当中，超过76％，这与使用替代技术。6,13其他以往的研究同情本地化EZ文献报道的成功。
正如任何侵入颅内程序，SEEG并非没有风险。幸运的是，SEEG插入报道非常低的并发症的危险。15</…
Disclosures
The authors have nothing to disclose.
Acknowledgements
作者没有确认。
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