神经内镜手术治疗透明隔囊肿伴发癫痫:附7例分析  

Endoscopic surgical therapy septum pellucidum cysts with epilepsy : analysis of 7 cases

作　　者：王林[1] 凌士营[1] 牛朝诗[1] 刘向[1,2] 魏祥品 钱若兵[1] 傅先明[1] 汪业汉[1] 

机构地区：[1]安徽省立医院神经外科,脑功能与脑疾病安徽省重点实验室,合肥230001 [2]安徽省脑立体定向神经外科研究所

出　　处：《立体定向和功能性神经外科杂志》2013年第3期145-148,共4页Chinese Journal of Stereotactic and Functional Neurosurgery

摘　　要：目的探讨透明隔囊肿伴发癫痫的机理、诊断及神经内窥镜手术疗效。方法针对7例透明隔囊肿伴发癫痫患者进行神经导航辅助神经内镜单侧造漏手术治疗,手术后定期随访,分析患者临床资料。结果本组患者术前影像学及脑电图检查除透明隔囊肿外均未见明确的其他致痫灶,7例术后随访3个月～3年,平均22个月,7例癫痫患者中,4例坚持术后口服抗癫痫药3例未发作、1例偶发,3例术后未规律服药癫痫1例无发作、1例偶有发作、1例频发。复查CT或MRI显示囊肿横径均不同程度缩小,膨胀性状态消失,囊肿双边内凹或平直。随访期间,无发作患者复查脑电图基本正常,发作患者术后早期仍存在偶发棘尖波,6个月后棘尖波消失。结论透明隔囊肿占位效应可以导致癫痫发作,应用神经内镜行囊肿侧脑室单侧造瘘术具有微创、安全优点,癫痫症状缓解较理想。Objective To investigate the septum pellucidum cysts with epilepsy mechanism,clinical diagnosis of and neurological endoscopic surgical treatment.Methods For seven cases septum pellucidum cysts with epilepsy endoscopic surgical treatment,regular follow-up after surgery,clinical data analysis.Results The preoperative imaging and EEG outside except septum pellucidum cysts showed no clear other epileptic foci,seven cases were followed up for 3months to 3years,an average of 22months,seven cases with seizures in four cases persist after oral administration of antiepileptic drugs three cases did not attack,one case of sporadic,3patients did not rule one case of epilepsy medication without seizures,one case of occasional seizures,one case frequently.CT scan or MRI showed the cyst diameter were reduced to varying degrees,the expansion of state disappeared,bilateral cysts concave or straight.No attack patients during follow-up review of EEG were normal,early onset patients still occasional spike sharp waves,in June after the sharp spike wave disappeared.Conclusion Septum pellucidum cysts mass effect can lead to seizures,Neuroendoscopy unilateral lateral cyst gastrostomy with minimally invasive,safe advantage,epilepsy treatment effect is good.

关 键 词：透明隔囊肿 癫痫 神经内镜 

分 类 号：R742.1[医药卫生—神经病学与精神病学]