neurosurgeryНейрохирургияRussian journal of neurosurgery1683-32952587-7569Издательский дом "МедИНК"10.24412/2587-7569-2025-1-22-32neurosurgery-1644Research ArticleОРИГИНАЛЬНАЯ РАБОТАORIGINAL REPORTВлияние параметров радиочастотной термокоагуляции на размер очага деструкции во время стерео-ЭЭГRadiofrequency thermocoagulation parameters impact on lesion size during stereo-EEGhttps://orcid.org/0000-0003-1800-1055ГордееваЕ. А.GordeyevaE. A.

Гордеева Елизавета Александровна.

105203 Москва, ул. Нижняя Первомайская, 70

Elizaveta A. Gordeyeva.

70 Nizhnyaya Pervomayskaya St., Moscow 105203

lis.gordeyeva@gmail.comhttps://orcid.org/0000-0003-4578-2205ДимерцевА. В.DimertsevA. V.

105203 Москва, ул. Нижняя Первомайская, 70

70 Nizhnyaya Pervomayskaya St., Moscow 105203

https://orcid.org/0000-0002-6233-9283СаламовИ. П.SalamovI. P.

Республика Дагестан, 367026 Махачкала, ул. Ляхова, 47

47 Lyakhova St., Republic of Dagestan, Mahachkala, 367026

https://orcid.org/0000-0002-4620-9083ИвинН. О.IvinN. O.

105203 Москва, ул. Нижняя Первомайская, 70

70 Nizhnyaya Pervomayskaya St., Moscow 105203

https://orcid.org/0000-0003-2974-1462ЗуевА. А.ZuevA. A.

105203 Москва, ул. Нижняя Первомайская, 70

70 Nizhnyaya Pervomayskaya St., Moscow 105203

ФГБУ «Национальный медико-хирургический центр им. Н.И. Пирогова» Минздрава РоссииРоссияN.I. Pirogov National Medical and Surgical Center, Ministry of Health of RussiaRussian FederationГБУ РД «Республиканская клиническая больница им. А.В. Вишневского»РоссияA.V. Vishnevsky Republican State HospitalRussian Federation2025190420252712232Copyright © Гордеева Е.А., Димерцев А.В., Саламов И.П., Ивин Н.О., Зуев А.А., 20252025Гордеева Е.А., Димерцев А.В., Саламов И.П., Ивин Н.О., Зуев А.А.Gordeyeva E.A., Dimertsev A.V., Salamov I.P., Ivin N.O., Zuev A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therjn.com/jour/article/view/1644Введение

Введение. Радиочастотная термокоагуляция эпилептогенной зоны через установленные стерео-электроды может быть альтернативой резективной операции у пациентов с фармакорезистентной эпилепсией.

Цель исследования – определить параметры радиочастотной термокоагуляции, влияющие на объем очага деструкции.

Материалы и методы

Материалы и методы. Проведено исследование на материале белков куриных яиц. С помощью глубинных электродов с использованием различных параметров вызваны различные по объему очаги деструкции. Отобраны 2 пациента, прошедшие процедуру стерео-электроэнцефалографии в НМХЦ им. Н.И. Пирогова, данные которых (размер очага деструкции и его влияние на течение заболевания) представлены в качестве примеров использования метода в клинической практике.

Результаты

Результаты. Наибольший очаг деструкции получен в результате радиочастотной термокоагуляции на мощности 3 Вт длительностью 180 с, проведенной между соседними контактами 1 электрода. Радиочастотная термокоагуляция по этой технологии в клинической практике в одном случае позволила разрушить эпилептогенную зону частично, во втором – полностью.

Радиочастотная термокоагуляция позволяет добиться свободы от приступов или снижения их частоты и интенсивности у пациентов с фармакорезистентной эпилепсией. Обнаруженные нами связи параметров радиочастотной термокоагуляции с параметрами формируемых очагов сходны с представленными в других работах.

Заключение

Заключение. Наибольшие очаги деструкции формируются в результате радиочастотной термокоагуляции с меньшей мощностью и более длительной экспозицией. На эффективность радиочастотной термокоагуляции в качестве терапии эпилепсии влияет соотношение размера полученного очага деструкции и размера эпилептогенной зоны.

Background

Background. Radiofrequency thermocoagulation of the epileptogenic zone via depth stereo electrodes may be an alternative to resective surgery in patients with drug-resistant epilepsy.

Aim

Aim. To determine the parameters of radiofrequency thermocoagulation that affect the lesion volume.

Materials and methods

Materials and methods. A study was conducted using chicken egg whites. With the help of depth electrodes, lesions of different volumes were produced at different parameters. Data of two patients who underwent stereoelectroencephalography at the N.I. Pirogov National Medical Clinical Center (the size of the focus of destruction and its effect on the course of the disease) are presented as examples of the use of the method in clinical practice.

Results

Results. The largest lesion was created at a power of 3 W for 180 seconds between adjacent contacts of one electrode. Using this technology in clinical practice allowed partial destruction of the epileptogenic zone in one case and complete destruction in the second.

Radiofrequency thermocoagulation allows to achieve seizure freedom or a reduction in their frequency and intensity in patients with drug-resistant epilepsy. The relationships we discovered between the parameters of radiofrequency thermocoagulation and the parameters of the formed lesions are similar to those presented in other works.

Conclusion

Conclusion. The largest lesions are formed as a result of radiofrequency thermocoagulation with lower power and longer exposure. The effectiveness of radiofrequency thermocoagulation as a treatment for epilepsy is influenced by the ratio of the lesion size and the size of the epileptogenic zone.

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The authors declare that there are no conflicts of interest present.