扣带回归性癫痫的外科治疗虽然罕见而富有挑战性，但却能取得良好的癫痫治疗效果。在这些患者身上，侵入性EEG监测通常是必要的，以评估癫痫发生区。目前，只有少量的手术病例系列公开发表，并且对于这些复杂病例的处理意见并不统一。本文作者回顾性分析了一个大型的手术病例系列，这些患者中至少有部分扣带回被立体电子脑图EEG证实为包含于癫痫发生区，并因此被切除。共选择了127名患者。在62名患者（48.8%）的右半球和44名患者（34.7%）的左半球中，进行了立体电子脑图引导下的颅内电极植入，而21名患者（16.5%）则接受了双侧植入。每位患者植入的电极数量中位数为13（四分位距12-15）。针对扣带回的电极数量中位数为4（四分位距3-5）。扣带回被双侧探测的患者有19名（15%）。并发症率为0.8%。在54.3%的患者中获得了良好的疗效（Engel I级），随访中位数为60个月。在组织学诊断为IIb型局部皮质发育不良或肿瘤（大多数为神经胶母细胞瘤或胚胎性神经外上皮瘤）患者以及男性，获得癫痫自由的几率增加。频繁发作的癫痫预示着更好的疗效，但趋势尚未显著。我们的研究结果表明，立体电子脑电图在处理涉及扣带回的复杂癫痫病例中是一种安全有效的方法。美国临床神经生理学协会版权所有。

Surgical treatment of cingulate gyrus epilepsy is associated with good results on seizures despite its rarity and challenging aspects. Invasive EEG monitoring is often mandatory to assess the epileptogenic zone in these patients. To date, only small surgical series have been published, and a consensus about management of these complex cases did not emerge. The authors retrospectively analyzed a large surgical series of patients in whom at least part of the cingulate gyrus was confirmed as included in the epileptogenic zone by means of stereo-electroencephalography and was thus resected. One hundred twenty-seven patients were selected. Stereo-electroencephalography-guided implantation of intracerebral electrodes was performed in the right hemisphere in 62 patients (48.8%) and in the left hemisphere in 44 patients (34.7%), whereas 21 patients (16.5%) underwent bilateral implantations. The median number of implanted electrodes per patient was 13 (interquartile range 12-15). The median number of electrodes targeting the cingulate gyrus was 4 (interquartile range 3-5). The cingulate gyrus was explored bilaterally in 19 patients (15%). Complication rate was 0.8%. A favorable outcome (Engel class I) was obtained in 54.3% of patients, with a median follow-up of 60 months. The chance to obtain seizure freedom increased in cases in whom histologic diagnosis was type-IIb focal cortical dysplasia or tumor (mostly ganglioglioma or dysembryoplastic neuroepithelial tumor) and with male gender. Higher seizure frequency predicted better outcome with a trend toward significance. Our findings suggest that stereo-electroencephalography is a safe and effective methodology in achieving seizure freedom in complex cases of epilepsy with cingulate gyrus involvement.Copyright © 2023 by the American Clinical Neurophysiology Society.