偏侧惊厥-偏瘫-癫痫综合征的外科治疗

目的 探讨偏侧惊厥-偏瘫-癫痫(HHE)综合征的临床特征及外科治疗效果.方法 对我院2004年-2009年收治的7例HHE综合征患者的临床资料进行分析,总结其临床、影像及脑电图特点,随访手术治疗后效果.结果 7例患者中2例为特发性HHE综合征,5例为症状性HHE综合征.其中4例患者行解剖性大脑半球切除术,2例患者行功能性大脑半球切除术,1例患者行颞前叶、颞叶内侧结构及顶后枕叶切除.术后随访5-32个月,Engel Ⅰ级4例,Engel Ⅱ级2例,Engel Ⅲ级1例.结论 HHE综合征在药物控制效果欠佳的情况下,可采用外科手术干预治疗,有助于改善患者的预后及生活质量.

The surgical treatment of hemiconvulsion hemiplegia epilepsy syndrome

Objective To summarize the clinical characteristics and prognosis of surgical treatment on hemiconvulsion hemiplegia epilepsy(HHE)syndrome. Method We included 7 patients who were diagnosed with HHE syndrome and underwent surgical treatment for intractable epilepsy at our hospital. The multidisciplinary presurgical evaluations included brain MRI, video - EEG monitoring and analysis of serum. Hemispherectomy, cortical resection for multilobe epileptogenic lesion were performed according to the results of presurgical evaluations. Results 5 cases were diagnosed as primary HHE,while 2 cases secondary HHE. 4 cases were operated with Adame's modified hemispherectomy(AH), 2 cases were operated with functional hemispherectomy(FH)and 1 case with cortical resection for multilobe epileptogenic lesion. During 5 to 32 months follow up,4 cases had seizure free(Engel Ⅰ),3 cases with alleviation of seizures(2 cases with Engel Ⅱ and 1 with Engel Ⅲ). Conclusions Surgical intervention may be helpful in patients with intractable epilepsy in HHE syndrome. Hemispherectomy is a viable alternative, which should be considered in the treatment of HHE based on the pre - evaluations.