难治性枕叶癫痫的术前定位与手术治疗  

Surgical treatment and preoperative evaluation of intractable occipital lobe epilepsy

作　　者：杜浩[1] 徐国政[1] 宋健[1] 黄河[1] 黄玲玥[1] 向露[1] 

机构地区：[1]广州军区武汉总医院神经外科,武汉430070

出　　处：《中国临床神经外科杂志》2014年第10期577-580,共4页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨难治性枕叶癫痫的术前定位与手术方法。方法对经手术治疗且随访时间6个月以上的9例枕叶癫痫患者的临床资料进行回顾性分析。采用发作症状评估、影像学检查、长程视频头皮脑电图监测、颅内电极脑电图记录等方法综合术前定位。根据术前定位确定的致痫灶部位与范围采用不同的手术方法。7例病人采用颅内电极置入术来精确定位。局部枕叶皮层切除2例,枕叶大部或全部切除4例,全枕叶或后头部脑叶离断3例;同期经枕入路切除或离断颞叶内结结构3例。结果术后随访6个月至2年,术后癫痫无发作6例,发作1次1例,发作减少90%以上2例。结论难治性枕叶癫痫经手术治疗可以取得较好的疗效,颅内电极脑电图记录有助于致痫灶准确定位,并指导术中切除部位与功能保护。Objective To explore the surgical technique and preoperative evaluations of intractable occipital lobe epilepsy. Methods The clinical data of 9 patients with occipital lobe epilepsy, who were surgically treated and followed up at last 6 months after the operation, were analyzed retrospectively. The semiology episodic and neuroimaging features, scalp long-term video-EEG monitoring and intracranial EEG monitoring were used for localizing epileptogenic zones before the surgery. The surgical strategies were selected according to the location and size of epileptogenic zones. Results The epileptogenic zones were accurately located by the intracranial EEG in 7 patients. The following-up from 6 to 24 moths showed that seizures were completely controlled in 6 patients, there was only one seizure in 1 patient, and seizures decreased by more than 90% in 2 patients during the following up. Conclusion The intracranial EEG monitoring is helpful to locating the epileptogenic zones and guiding the resection of the epileptogenic zones. The curative effect of the surgery on the intractable occipital lobe epilepsy is good.

关 键 词：枕叶癫痫 手术 术前定位 疗效 

分 类 号：R742.1[医药卫生—神经病学与精神病学] R651.11[医药卫生—临床医学]