功能区外伤性癫痫的临床分析及综合手术治疗

目的总结功能区外伤性癫痫的临床特征及将几种术式联合治疗的效果。方法根据术前对32例病人的临床分析和痫灶定位检查,术中采用皮质脑电图监测,术式包括疤痕松解术、致痫灶切除术、前颞叶切除术、前颞叶及海马切除术、胼胝体切开术和多处软膜下横纤维切断术,术后随访2～3年。结果17例癫痫发作完全消失;9例癫痫发作显著减少,效果良好;4例疗效差;无明显改善2例,手术总有效率达81.25%(26/32)。结论选择适当的手术方式治疗功能区外伤性癫痫可取得较好的疗效。

Clinical Analysis and Surgical Treatment of Posttraumatic Epilepsy in Functional Cerebral Area

Objectives To summarize the clinical features of posttraumatic epilepsy in the functional cerebral area and to evaluate the curative effect of the combined operations on it. Methods Before the operation, the clinical analysis and examinations to locate epileotogenic foci were performed in 32 patients with postraumatic epilepsy of functional cerebral area. And then the patients underwent combined comprehensive operation including cicatrectomy, the resection of the epileptogenic foci, anterior temporal lobectomy, anterior temporal lobectomy and hippocampectomy, corpus callosotomy and multiple subpial transection. The electrocor-ticogram(ECoG) monitoring was used during the operation. All the patients were the followed up from 2 to 3 years. Results The seizure stopped in 17 cases, the significantly decreased in 9 and insignificantly decreased in 6. The effective rate was 81.25% (26/32). Conclusion The comprehensive surgical operation is an effective method to treat the refractory prostraumatic epilepsy in the functional cerebral area.