难治性无明确致癎灶癫癎的立体定向手术治疗  

Therapeutic effect of stereotactic surgery on refractory epilepsy with no definitive epileptic focus

作　　者：王一芳[1] 谭启富[2] 许爱刚[1] 王正伟[1] 

机构地区：[1]解放军第454医院神经外科,南京210002 [2]南京军区南京总医院

出　　处：《临床神经外科杂志》2011年第6期309-311,共3页Journal of Clinical Neurosurgery

基　　金：南京军区医学科学"十一五"科研项目(09ma054)

摘　　要：目的探讨立体定向射频毁损手术对难治性无明确致癎灶癫癎的治疗效果。方法经脑电图、MRI、脑磁图(MEG)检查等术前综合评估无法确定致癎灶的难治性癫癎患者78例,采用立体定向技术进行胼胝体两侧、双侧杏仁核、内侧隔区及单侧Forel-H区等多靶点组合射频毁损治疗,手术后对患者进行跟踪随访、评定疗效。结果按照Engle癫癎疗效分级,本组患者术后1～5年I级+Ⅱ级病例均达82%以上。结论对于临床无明确致癎灶、无法进行开颅致癎灶切除手术的难治性癫癎患者,立体定向手术是一种较好的治疗手段。Objective To explore the therapeutic effect of stereotactic surgery on patients of refractory epilepsy with no definitive epileptic focus. Methods 78 patients of refractory epilepsy with no definitive epileptic focus were diagnosed by electroencephalogram （EEG）, magnetic resonance image （MRI） and magnetoencephalography （MEG）. These patients were treated by stereotactic techniques, multi-nucleus lesion by radio-frequency equipment. The therapeutic effect was evaluated during the follow-up. Results One year to five years later, according to Engle standard of curative effect, the percentage class I plus class 11 was over 82% among the operated patients every year. Conclusion For the patients of refractory epilepsy with no definitive epileptic focus, the lesion of bilateral corpus callosum , bilateral amygdala , bilateral medial septal area and unilateral Forel-H area might be an effective treatment method.

关 键 词：立体定向 癫癎 胼胝体 内侧隔区 杏仁核 

分 类 号：R742.1[医药卫生—神经病学与精神病学]