摘要
目的探讨伽玛刀治疗运动功能区癫痫的最佳剂量、疗效及术前评估方法。方法 11例运动功能区癫痫患者通过5项主要评估指标〔临床症状、视频脑电图(VEEG)、MRI、脑磁图(MEG)、单光子发射计算机断层成像(SPECT/PET),考虑运动功能区癫痫者,加做运动功能区定位〕确定癫痫灶部位,行伽玛刀治疗。周边剂量11～14 Gy/50%,术前术后行心理状态及智力评估。结果按国际癫痫学会外科手术疗效分类法,有效率为10/11,患者在心理状态、智商等方面也得到明显改善;12 Gy组Ⅰ级例数最多,4例中3例达到Ⅰ级;14 Gy组并发症例数最多,3例中有2例出现并发症。结论伽玛刀治疗可较满意控制运动功能区癫痫发作,安全、损伤小;可以改善癫痫患者的心理状态及智力水平;治疗的关键在于严格把握术前评估,尤其是VEEG及放射剂量,低剂量伽玛刀治疗效果较好,12 Gy剂量治疗效果更好。
Objective To explore the best dose,the efficacy and preoperative evaluation system in gamma knife treatment of epileptic motor function areas.Methods 11 patients with epilepsy in motor function area were confirmed epileptogenic focus by five main evaluation indicators（clinical features,VEEG,MRI,MEG,SPECT/PET,positioning of motor function area were performed considering the patients with epilepsy in motor function area）,and then they were treated by gamma knife.Peripheral dose was 11 ～ 14 Gy/50%.Evaluation of mental status and intelligence were performed before and after surgery.Results The effective rate was 10 /11 according to surgery efficacy classification of International Society for Epilepsy.The mental status and intelligence were also improved significantly.12 Gy group had the most level-1 cases,with 3 in 4 achieving level-1;14 Gy group had the most cases with complications,with 2 in 3 appearing complications.Conclusion The gamma knife treatment can control effectively the seizure of epilepsy in motor function areas with more security and less damage.It can also improve patients＇mental status and intelligence level.Preoperative evaluation,particularly the evaluation of VEEG and dose,is the key for the treatment.Gamma knife has a better efficacy in low dose,with 12 Gy having the best efficacy.
出处
《中国全科医学》
CAS
CSCD
北大核心
2010年第33期3721-3724,共4页
Chinese General Practice
基金
河北省自然科学基金(C2007000947)
关键词
运动功能区癫痫
术前评估
伽玛刀
最佳剂量
疗效
Motor area epilepsy
Preoperative evaluation
Gamma knife
Optimal dosage
Efficacy
