中央区难治性癫痫的外科治疗  

Surgical treatment of rolandic intractable epilepsy

作　　者：石先俊 孙晓琴 冯林 邓静 张春青 吕胜青 刘仕勇 Shi Xianjun;Sun Xiaoqin;Feng lin(Department of Neurosurgery,Xinqiao Hospital,Army Medical University,400037 Chongqing,China)

机构地区：[1]陆军军医大学新桥医院神经外科,重庆400037

出　　处：《立体定向和功能性神经外科杂志》2023年第3期129-134,共6页Chinese Journal of Stereotactic and Functional Neurosurgery

摘　　要：目的探讨外科治疗中央区难治性癫痫的方法和疗效。方法回顾性分析2017年7月~2021年8月诊断为中央区难治性癫痫且接受外科治疗的患者的临床资料。结果31例患者纳入研究,其中男20例,女11例,年龄中位数是14(9,23),儿童19例,成人12例。手术切除治疗22例,平均随访3.0±1.1年,EngelⅠ级17例(77.3%),轻度神经功能障碍3例(13.6%)。射频热凝治疗8例,随访中位数1.5(1.2,1.8)年,EngelⅠ级5例(62.5%),未出现明显神经功能障碍。迷走神经治疗1例,随访2年,EngelⅢ级。结论外科治疗中央区癫痫安全有效;精准定位功能区与致痫灶的关系是保证疗效和避免神经功能障碍的关键;射频热凝术是治疗中央区癫痫的新方法。Objective To investigate the methods and efficacy of surgical treatment of rolandicintractable epilepsy.Methods The clinical data of patients who were diagnosed with rolandicintractable epilepsy and underwent surgical treatment between July,2017and August,2021 were retrospectively analyzed.Results A total of 31patients were enrolled in the study,including 20males and 11females,with a median age of 14(9,23),19children and 12adults.22patients were treated with surgical resection,with an average follow-up of 3.0±1.1years.17patients(77.3%)had EngelⅠ,and 3patients(13.6%)had mild neurological dysfunction.8patients were treated with radiofrequency thermocoagulation,and the median follow-up time was 1.5(1.2,1.8)years.5patients(62.5%)were EngelⅠ,and no obvious neurological dysfunction occurred.One patient was treated with vagus nerve stimulation and was followed up for 2years with Engel III.Conclusion Surgical treatment of rolandic epilepsy is safe and effective.Accurate localization of the relationship between functional area and epileptogenic zone is the key to ensure curative effect and avoid neurological dysfunction.Radiofrequency thermocoagulation is a new method for the treatment of rolandic epilepsy.

关 键 词：中央区癫痫 癫痫手术 射频热凝 迷走神经刺激 

分 类 号：R742.1[医药卫生—神经病学与精神病学]