额叶癫痫手术患者MRI检查及对预后评估的价值

目的:评估术前MRI检查对药物难治性额叶癫痫手术患者术后6个月及1年预后的作用。方法:通过MRI等影像学检查及电临床症状学等评估手段确诊为额叶癫痫的患者20例,按照MRI检查有无异常发现分为两组,I组:MRI未发现病灶7例,II组:MRI有明确病灶13例,经过手术治疗后,随访半年及1年,按照Engle术后疗效评估分级法,并应用SPSS17.0软件计算两组在短期预后上有无显著性差异。结果:20例患者术后半年达到Engle分级I级13例,占65.0%,术后1年达到Engle分级I级11例,占55.0%,其中I组患者术后半年达到Engle分级I级2例,占28.6%,术后1年达到Engle分级I级1例,占14.3%,而II组患者术后半年达到Engle分级I级11例,占84.6%,术后1年达到Engle分级I级10例,占76.9%,两组患者在手术疗效上有显著性差异(P<0.05)。结论:手术切除癫痫病灶是药物难治性额叶癫痫的有效治疗方法,有明确病灶且病灶与癫痫发作相关的患者手术术后效果较好,针对MRI未见明确异常的患者可行颅内电极植入,对于深部癫痫病灶的评估具有明确作用。

The relationship between preoperative MRI and prognosis of frontal lobectomy

Objective.. To assess the relationship between preoperative MRI and prognosis of refractory frontal epilepsy treated by frontal lobectomy after half an year and one year. Methods In 20 frontal lobe epilepsy patients diagnosed by ictal semeiology and video EEG, we divided them into two groups according to MRI, there were 7 patients with non lesional in group Ⅰ, and 13 patients in group Ⅱ with lesional. We calculated the statistical difference between group I and group II according to Engle classification of postoperative outcome. Results;In 20 pa- tients, 13 patients were seizure-free（Engle I） half-an-year after surgery, Ⅱ patients were seizure-free one year after suegery. 2 patients were seizure-free half-ayear after surgery, and the number was 1 one year after surgery in group Ⅰ.Ⅱ patients were seizure-free half-an-year after surgery, and the number was 10 one year after surgery in group Ⅱ. There was statistical difference between the two groups. Conclusion Epilepsy surgery evolved to an effec tive treatment option for refractory frontal lobe epilepsy The patients with lesions correlated to clinical seizure should be treated by surgery, and the outcome is good. Intracranial electrode electroencephalogram is an effective method to assess the lesion of epilepsy.