MRI显示双侧病变的难治性癫痫患者的外科治疗  

The surgical treatment for intractable epilepsy patients with MRI documented lesions located bilaterally

作　　者：马炜[1] 李焕发[1] 张华[1] 王超[1] 孟强[1] 刘备[1] 武昊[1] 董珊[1] 

机构地区：[1]第四军医大学唐都医院神经外科,全军功能神经外科研究所,西安710038

出　　处：《立体定向和功能性神经外科杂志》2015年第2期74-76,79,共4页Chinese Journal of Stereotactic and Functional Neurosurgery

基　　金：国家自然科学基金资助项目(编号:81271433)

摘　　要：目的探讨MRI显示为双侧病变的难治性癫痫患者的外科手术治疗及疗效。方法回顾性分析29例MRI显示为双侧病变的难治性癫痫患者的临床症状、电生理、影像、手术及术后随访资料。结果通过综合的术前定位评估,均能明确致痫的责任病灶,并行手术切除或合并部分胼胝体切开,术后随访7~40个月,疗效按Engel分级,Ⅰ级17例,Ⅱ级5例,Ⅲ4级例,Ⅳ级2例,失随访1例,无永久性神经功能缺陷发生。结论 MRI显示的双侧病变并非都是引起癫痫发作的原因,通过综合的术前定位评估能明确致痫责任病灶的患者,行外科切除手术治疗能获得很好的控制疗效。Objective To explore the surgical treatment and results of the intractable epilepsy patients with MRI documented lesions located bilaterally.Methods We retrospectively analyzed the semiology,electrophysiology,imaging,surgery and follow-up data of 29 intractable epilepsy patients with lesions located bilaterally.Results After comprehensive presurgical assessment,a responsible epileptogenic foci can be defined in all of the patients,surgical resection or plus partial corpus callosotomy was performed in all patients.The follow-up lasts from 7~40months,except for one patient last follow-up,the control effect reached Engel class Ⅰ in 17,classⅡ in 5,classⅢ in 4and classⅣ in 2according to Engel classification,and there was no permanent functional deficit happened.Conclusion The lesions revealed by MRI were not always the reasons responsible for epileptic seizure,agood seizure control can be reached by surgical resection when a responsible foci identified by a comprehensive presurgical evaluation.

关 键 词：癫痫 MRI 双侧 病变 外科治疗 

分 类 号：R742.1[医药卫生—神经病学与精神病学]