岛叶癫痫的外科治疗与随访  

Surgical treatment of insular epilepsy cases and follow-up of efficacy

作　　者：刘庆祝[1] 王晓飞[1] 梅珊珊[1] 马康平[1] 郑瑞峰[1] 代金东[1] 易林华[1] 张景[1] 李云林[1] 

机构地区：[1]北京市海淀医院功能神经科,100080

出　　处：《中华神经外科杂志》2014年第2期162-165,共4页Chinese Journal of Neurosurgery

基　　金：国家自然科学基金（81071211）

摘　　要：目的探讨岛叶癫痫的发作特点及手术策略，观察手术疗效。方法分析7例岛叶癫痫患者的术前评估结果，总结症状学特征、MRI、头皮及颅内电极视频脑电图检查的定位价值，应用Engel标准进行术后效果分级，随访观察术后疗效。结果左侧5例，右侧4例，发作主要表现：植物神经症状；躯体感觉、运动症状；语言、味觉、听觉障碍等症状。Engel分级I级2例，Ⅱ级2例，Ⅲ级1例，2例术后3个月无发作。结论颅内电极置人是临床诊断岛叶癫痫的重要手段，手术切除可获得满意的癫痫控制效果。Objective To investigate the characteristics of insular seizures and surgical strategies, and to observe the efficacy of surgical treatment. Methods Preoperative evaluation results of seven patients with insular epilepsy were analyzed. Symptomatic characteristics, MRI, scalp video-EEG, and localization value of EEG examination with intracranial electrode were summarized. Engel standards were applied to grade postoperative effects. Patients were followed to observe the efficacy after operation. Results In the seven patients, lesions of three cases were on the left and four cases were on the right. Their symptoms were mainly as follows ： autonomic symptoms; somatosensory and motor symptoms ; language, taste, hearing disorders and other symptoms. Two cases were graded at level I , two cases were graded at level Ⅱ, one case was graded at level ,two cases were seizure free for three months according to Engel standards. Conclusions Placement of intracranial electrode is an important means for the clinical diagnosis of insular epilepsy. Satisfactory seizure control can be obtained by surgical resection for insular epilepsy.

关 键 词：岛叶癫痫 术前评估 手术 疗效 

分 类 号：R742.1[医药卫生—神经病学与精神病学]