多软膜下横切术对外伤性功能区顽固性癫痫的治疗  

Epileptogenic lesionectomy combined with multiple subpial transection for the treatment of post-traumatic intractable epilepsy

作　　者：陈亮文 匡永勤[2] 顾建文[2] 杨立斌[2] 卢敏[2] 郎志刚[2] 马原[2] 

机构地区：[1]广东省东莞市南城医院,523000 [2]成都军区总医院神经外科,成都610083

出　　处：《中华神经医学杂志》2005年第6期610-611,共2页Chinese Journal of Neuromedicine

摘　　要：目的探讨癫痫病灶切除辅以多处软膜下横切术(MST)对外伤性癫痫治疗的临床效果。方法32例外伤性癫痫中,癫痫病灶切除加MST28例,癫痫病灶切除加MST和胼胝体前2/3潜行切开术4例;术后12￣36个月随访观察。结果术后早期可见6例一过性肢体肌力减弱,11例一过性失语,均在5￣10d内恢复;32例手术出院后12￣36个月随访,完全无发作13例,发作次数减少75%以上10例,发作次数减少51%￣75%6例,3例效差或无改善。结论癫痫病灶切除加MST是治疗外伤性癫痫安全且有效的方法。Objective To investigate the clinical effects of epileptogenic lesionectomy combined with multiple subpial transection (MST) for the treatment of post-traumatic epilepsy (PTE). Methods In 32 cases with PTE treated in our hospital from 2000 to 2004,28 cases accepted epileptogenic lesionectomy combined with MST,and the other 4 cases added with anterior 2/3 corpus callosotomy. All were followed up 12~36 months after the surgery. Results 6 cases showed a transient decreased limb muscle power and 11 cases had transient aphasia in early period after operation,but all recovered in 5~10 d later. Seizure disappeared totally in 13 cases (40.6%); the frequency decreased significantly (>75%) in 10 cases (31.2%),51%~75% in 6 cases (18.7%); poor effect or no improvement occurred in 3 cases. The total effective rate was 90.5%. Conclusion The epileptogenic lesion resection combined with MST is an effective and safe surgical technique in the treatment for PTE.

关 键 词：功能区顽固性癫痫 多软膜下横切术 多处软膜下横切术 外伤性癫痫 病灶切除 发作次数 临床效果 癫痫治疗 随访观察 肌力减弱 术后早期 MST 一过性 切开术 胼胝体 出院后 

分 类 号：R742.1[医药卫生—神经病学与精神病学] R742.105[医药卫生—临床医学]