有癫痫史的中枢海绵状血管瘤

目的 探讨有癫痫史的中枢神经系统海绵状血管瘤（CMs）病人的癫痫类型和手术疗效.方法回顾性分析一个医疗中心9年37例患者的资料,分析癫痫的类型、表现、病程、频率及病灶部位,行3年以上随访.结果本组无死亡病例,远期随访无神经功能障碍加重.癫痫完全控制76%,发作减少16%,无明显改善8%.导航下手术癫痫完全控制82%,常规手术完全控制71%.结论癫痫病程短,发作次数少,以部分性发作为主,未累及边缘系统,病变部位与临床表现、脑电图定位一致者手术效果好.应用神经导航辅助显微外科技术以及合理地应用外科手术入路是提高本病疗效的重要因素.

Epileptogenic cavernous malformations of the central nervous system

Objective To explore the relationship of cavernous malformations(CMs) and epileptic attacks (EA) , referred to the surgical outcomes. Methods A retrospective review was conducted in 37 patients with CM and EA treated in one medical center in 9 years. The clinical semiology, history and frequency of EA, as well as the location of the lesion are detailedly analyzed and the follow - up time for each case is over 3 years. Results 76% of the patients become seizure - free after surgery and 16% have a great reduction. Of those guided by neuronavigation, 82% become seizure - free, and accordingly 71% for those without neuronavigation. There was no surgical mortality and no aggravation of neurological deficit in long -term follow - up study. Conclusions In patients with a shorter EA history, or less frequently seizure, with the clinical features or the EEG localization entirely consistent with the location of the lesion, with the lesion not located in highly epileptogenic cortex referred to the limbic system, seizure control can be expected when surgical intervention is properly done. Application of neuronavigator - assisted microsurgical technique and rational selection of the surgical approach are essential.