外科手术治疗难治性癫痫(附99例病例报道)  

Surgical Treatment of Refractory Epilepsy:a Report of 99 Cases

作　　者：卢军[1] 蒋宇钢[1] 黄红星[2] 曾其昌[2] 王琴[2] 邹叔骋[2] 李波[2] 

机构地区：[1]中南大学湘雅二医院神经外科,湖南长沙410011 [2]湖南省脑科医院神经外科

出　　处：《实用预防医学》2009年第2期497-499,共3页Practical Preventive Medicine

摘　　要：目的研究难治性癫痫的致痫灶精确定位和外科手术治疗的方法及疗效。方法对99例难治性癫痫患者应用影像学、视频脑电图、PET-CT等检查综合行癫痫灶定位和多种术式进行外科手术治疗。结果随访评估疗效满意者51例(51.5%),显著改善31例(31.2%),良好6例(6%),较差7例(7%),无改善4例(4%)。除1例额顶叶星形细胞瘤术后有偏瘫,1例再次手术出现偏瘫、失语者,1例行立体定向手术后出现偏瘫外,其余无明显及永久性神经系统并发症,无死亡病例。结论应用影像学、电生理、PET-CT等检查进行术前癫痫灶定位和多种术式进行外科治疗,可使难治性癫痫的治疗获得满意疗效。Objective To study exact Iocalizations of epilepsy focus, the methods and curative effects of surgical operative treatment of refractory epilepsy. Methods By the comprehensive application of the imaging examination, VEEG, PET- CT, and so on, the epilepsy focus was precisely located, 99 patients with refractory epilepsy were treated by a variety of surgical procedures. Results The follow - up outcomes showed that 51 patients had satisfactory results （51.5%）, 31 patients had noticeable improvements （31.2 % ）, 6 patients had a good therapeutic effect （6 % ）, 7 patients showed a poor therapeutic effect （7 % ）, and 4 patients showed no change （4 % ）. Except one patient with hem iplegia after astrocytoma operation, one patient with hemiplegia and aphasia occurred after the second operation, and one patient with hemiplegia after stereotactic operation, there were no serious and forever complications and no death. Conclusions Application of imaging procedures, electrophysiology, PET- CT for preoperative localization foci and a variety of foci for surgical treatment technique allows refractory epilepsy obtained a satisfactory effect.

关 键 词：难治性癫痫 外科手术 痫灶定位 

分 类 号：R742.1[医药卫生—神经病学与精神病学]