Sturge-Weber综合征所致难治性癫痫的手术治疗  

Surgery for refractory epilepsy caused by Sturge-Weber syndrome

作　　者：刘长青[1] 陈思畅 关宇光[1] 周健[1] 翟峰[1] 栾国明[1] 

机构地区：[1]首都医科大学三博脑科医院功能神经外科,北京100093

出　　处：《中国临床神经外科杂志》2017年第6期379-381,385,共4页Chinese Journal of Clinical Neurosurgery

基　　金：首都医科大学基础临床合作课题(13JL51);首都临床特色应用研究(Z131107002213169);首都卫生发展科研专项(2016-4-8011)

摘　　要：目的探讨Sturge-Weber综合征所致难治性癫痫的手术方法以及其疗效。方法回顾性分析2009年4月至2016年4月手术治疗30例Sturge-Weber综合征所致难治性癫痫的临床资料。结果术后随访3个月至6.1年,按Engel分级评估疗效,EngelⅠ级24例,Ⅱ级4例,Ⅳ级2例。术后未见永久性功能障碍。10例术后出现对侧肢体肌力下降1~3级,大部分在3个月后恢复至术前水平;1例出现感觉性失语,术后3个月恢复正常。结论手术是治疗Sturge-Weber综合征所致难治性癫痫的安全有效的措施。根据病人年龄、神经功能,病变部位及范围不同,采取不同的手术方式,可在控制癫痫发作的同时最大限度保留神经功能。Objective To investigate the surgical method to treat refractory epilepsy caused by Sturge-Weber syndrome and its curative effect. Method The clinical data of 30 patients with of refractory epilepsy caused by Sturge-Weber syndrome undergoing surgery from April, 2009 to April, 2016 were analyzed retrospectively. Results All the patients were followed up from 0.25~6.1 years. The following up showed that the epilepsy control belonged in Engel grade Ⅰ in 24 cases, grade Ⅱ in 4 and grade Ⅳ in 2. The contralateral limb muscle strength decreased by grade 1 to 3 on discharge from the hospital compared with that before the operation in 10 patients, in whom the muscle strength returned to the normal 3 months after the operation. The speech returned to normal 3 months after the operation in 1 patient with sensory aphasia immediately after the operation. There was no permanent functional impairment after the operation. Conclusions Surgery is a safe and effective method to treat refractory epilepsy caused by Sturge-Weber syndrome. The different surgical fashion chosen according to the patient＇s age, neurological function and location and range of the lesion is helpful to the control of epileptic seizures and maximal retention of nervous function.

关 键 词：STURGE-WEBER综合征 难治性癫痫 显微手术 皮层电凝热灼术 

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]