摘要
目的探讨病灶性难治性癫痫术前评估和手术治疗的方法。方法对40例病灶性难治性癫痫患者联合应用长程视频脑电图、磁共振成像、功能磁共振成像、磁共振波谱分析等方法进行术前评估，确定致痫灶与病灶的关系，采用单纯病灶切除术、病灶切除加周围皮质切除术、病灶切除加周围皮质软膜下横切术或皮层热灼术等手术方法，随访复查，评价临床效果。结果40例患者术前评估致痫灶与病灶位置基本一致，术中均应用皮层电极监测，与术前评估相符。术后随访11～48个月．EngelⅠ级30例（75．0％），Ⅱ级7例（17．5％），Ⅲ级2例（5．0％），Ⅳ级1例（2．5％）。36例（90％）患者生活质量改善。结论病灶性难治性癫痫，术前需应用长程视频脑电图、磁共振成像、功能磁共振成像、磁共振波谱分析等方法进行评估以明确病灶与致痫灶的关系，采用多种手术方法联合的方法是治疗病灶性难治性癫痫的有效途径。
Objective To investigate the methods of preoperative evaluation and the surgical management of lesional intractable epilepsy. Methods Based on the preoperative evaluation,epileptic focus was located by Video-EEG, MRI, fMRI, MRS and removed with different minimally invasive treatments including epileptic focus elimination, multiple lobectomy. Evaluated the effect of operations with the follow-up investigations. Results The onset zone was confirmed to be accurate in the localization with the lesions in 40 cases. All patients were followed up for 11-48 months postoperatively. According to the Engel standard of the curative effect,grade Engel Ⅰ accounted for 75.0% ,grade Ⅱ 17.5%,grade Ⅲ 5.0% ,and grade Ⅳ 2.5%, respectively. Quality of life markedly improved in 36 cases （90%）. Conclusion Based on the preoperative evaluation, epileptic focus located by Video-EEG, MRI, fMRI and MRS, it is an effective way to select appropriate surgical methods for treating the lesional epilepsy.
出处
《中国医师进修杂志（外科版）》
2007年第12期15-17,共3页
Chinese Journal of Postgraduates of Medicine
