立体定向毁损杏仁海马复合体治疗癫痫长期随访  

Long following-up stereotactic amygdalohippocampotomy for the intractable epilepsy

作　　者：潘云曦[1] 谭启富[1] 

机构地区：[1]南京军区南京总医院神经外科,210002

出　　处：《立体定向和功能性神经外科杂志》2003年第4期210-212,共3页Chinese Journal of Stereotactic and Functional Neurosurgery

摘　　要：目的　探讨立体定向射频毁损杏仁海马复合体 ,能否阻止癫痫放电的传播以治疗顽固性癫痫。方法　 1 7例顽固性癫痫病人应用ZD立体定向系统 ,CT扫描确定杏仁核和海马的靶点 ,分别毁损杏仁核和海马。术后常规MR复查了解靶点毁损的部位和大小 ,并排除并发症。结果　本组 1 7例 ,无手术并发症。随访 2～ 6年 ,平均3年 9个月 ,结果满意者 7例 (癫痫发作消失 ) ,显著改善者 7例 (癫痫发作减少 75 % ) ,无效者 1例 ,1例自行停药 2月后 ,癫痫发作又复发 ,再次服药后仍有癫痫发作。所有患者均需服药 ,药量无明显减少。结论　立体定向射频毁损杏仁海马复合体治疗癫痫 ,创伤小 ,安全 ,控制癫痫发作基本满意 。Objective To investigate the effect on stereotactic amygdalohippocampotomy for the intractable epilepsy through lesioning epileptic focus and cutting off the spread of epileptic discharge.Methods 17 patients with intractable epilepsy performed stereotactic radiofrequency lesioning of the amygdala and hypocampus by using directly CT localization for target planning.Postoperative MR brain scanning was performed for suring the place and size of targets,and excepting operative complications.All patients followed up at 2-6 years,mean 3 years and 9 months.Results In 7 of 17 patients the effect on control of seizure were good (seizure disappear);remarkable improvement(seizure decrease morn than 75%) in 7 patients;no effects in 1patient;After two months stopping antiepileptic agents himself patient recurred seizures,he still had seizure taking antiepileptic agents again.The postoperative dosage of taking antiepileptic agents were not less than the preoperative in all patients.There were no operative complications in all patients.Conclusions It is the long satisfying effects on control seizure,safe and small lesion that stereotactic amygdalohippocampotomy were performed for the intractable epilepsy.

关 键 词：立体定向毁损 杏仁核 海马 癫痫 随访 ZD立体定向系统 并发症 

分 类 号：R742.1[医药卫生—神经病学与精神病学]