半球切开术治疗顽固性癫痫  

Hemispherotomy for refractory epilepsy

作　　者：尹绍雅[1] 冯珂珂[1] 岳伟[2] 冯梅[3] 王世民[2] 张雪青[3] 

机构地区：[1]30060天津市环湖医院神经外科 [2]30060天津市环湖医院神经内科 [3]30060天津市环湖医院神经电生理科

出　　处：《中华神经外科杂志》2013年第7期714-718,共5页Chinese Journal of Neurosurgery

摘　　要：目的对于单侧大脑半球弥漫性病变引起的难治性癫痫，可以用大脑半球切除术或切开术治疗。本文总结作者最近进行的3例大脑半球切开术，同时进行了相应的文献复习。方法3例难治性癫痫，男2例，女1例，年龄分别为7、11、和15岁。均为一侧半球病变，其中实施大脑半球完全切开术2例，后象限切开术1例。手术的目的是完全孤立致痫区域。结果3例患者分别随访22、22、12个月，其中Engel IA2例，Engel II B1例。无长期神经功能障碍或死亡病例。结论应用神经纤维离断技术进行大脑半球切开，可获得与切除术相同的控制癫痫的良好效果。Objective Patients with unilateral epilepsy that is poorly controlled with medication are candidates for hemispherectomy or hemispherotomy. To evaluate the clinical usage of hemispherotomy in the epilepsy surgery. The authors studied retrospectively here on their 3 intractable epilepsy cases treated with hemispherotomy, and reviewed the related literature. Methods Retrospectively studied on 3 intractable epilepsy cases （2 male, 1 female; 7,11 and 15 years old respectively） with unilateral epilepsy and abnormal on MRI imaging. The surgical procedures included 2 cases of hemispherotomy and 1 case of post quadrant hemispherotomy. The epileptic area were completely isolated by disconnecting in these cases. Result The follow up period were 1,1, 0.4 year respectively in 3 cases. The seizure control result after surgery was Engel I A in 2 cases and Engel 11 B in one case. There was no new prolonged neurological deficit and death. Conclusion Disconnection or hemispherotomy resulted an excellent early seizure control as same as the hemispherectomy. The long - term efficacy and complication need more cases and long follow up.

关 键 词：大脑半球切开术 难治性癫痫 癫痫外科 

分 类 号：R651[医药卫生—外科学]