灰质异位所致癫痫的外科治疗

目的 探讨大脑灰质异位(HGM)与癫痫的关系,以及手术治疗的价值. 方法 回顾性分析解放军第四五八医院神经外科自2004年5月至2006年5月收治的6例HGM所致癫痫患者的临床特点、手术方式以及随访结果. 结果 6例患者中,4例行异位灰顶切除+皮层热灼,1例行异位灰顶切除+皮层热灼+前颞叶切除.1例行单纯皮层热灼.术后随访2～4年,5例至今未见发作,1例发作明显缓解. 结论 对于HGM所致的难治性癫痫,外科手术是一个有效的治疗方法.

Surgical treatment of epilepsy induced by gray matter heterotopia

Objective To explore the relationship between gray matter heterotopia and epilepsy and assess the therapeutic effect of surgical intervention. Methods Six cases of gray matter heterotopia-induced epilepsy treated in our department between May, 2004 and May, 2006 were analyzed retrospectively for the clinical characteristics, surgical approaches, and the outcomes in the 2- to 4-year-long follow-up. Results All the patients received surgical interventions through different approaches, including resection of the heterotopic gray matter plus bipolar coagulation of the cortexes in 4 cases, heterotopic gray matter resection with bipolar coagulation of the cortexes and temporal lobectomy in 1 case, and exclusive bipolar coagulation of the cortexes in 1 case. Five patients were free of seizure attach and 1 patient showed significantly reduced seizure attack after the operation. Conclusion Surgical intervention can be effective for treatment of intractable epilepsy induced by gray matter heterotopia.