中央区纵裂癫痫的手术治疗

目的 探讨中央区纵裂癫痫的诊断及手术治疗方法. 方法 选择自2007年6月至2008年4月在河北省人民医院功能神经外科就诊并接受手术治疗的6例中央区纵裂癫痫患者,常规术前评估(包括MRI、头皮脑电图、MEG、加密头皮脑电图、颅内埋藏电极及皮层电刺激联合定位致痫灶和功能区)后在皮层脑电临测下行手术切除,切除组织进行病理检查,术后随访发作情况、腩电图和并发症. 结果 经术前评估致痫灶均位于中央区纵裂区,经手术治疗后5例患者术后无发作,达到Engle Ⅰ级;1例EngleⅡ级,发作明显减少.术后病理结果显示,6例患者中局灶性皮层发育不良3例,胶质增生、脂肪瘤和海绵状血管瘤各1例.术后脑电图显示,大致正常脑电图3例,少量慢波3例. 结论 中央区纵裂癫痫在精确定位下可行手术切除,手术效果良好,无严重并发症.

Surgical treatment for epilepsy in the diastema of the central region

Objective To explore the operative treatment for epilepsy in the diastema of the central region. Methods We analyzed the data of 6 patients with epilepsy in the diastema of the central region,receiving surgical treatment in our hospital from Jun 2007 to Apr 2008.All the patients were performed conventional pre-operative assessments,including MRJ,scalp EEG,MEG,high-density scalp EEG,intracranial EEG and cortical electrical stimulation,to locate the epileptogenic zone and functional regions.Under the cortical EEG monitoring,surgical resection and pathological examination were performed,respectively.EEG characteristics and treatment outcomes,including seizure and complications,were followed up after surgery. Results Epileptogenic zones were localized in the medically refractory diastema of the central region.Five patients were seizure free(Engel Ⅰ)after surgery and 1 had rare seizures(Engel Ⅱ).Pathological examination demonstrated 3 with focal cortical dysplasia,and 1 with gliosis.1 with lipoma and 1 with cavernous hemangioma.Three were showed generally normal EEG and another 3 were showed a small amount of slow-waves by postoperative EEG.Conclusion Epilepsy in the diastema of the central region can be precisely resected without serious complications.