35例难治性癫痫的病灶定位和外科治疗

目的研究难治性癫痫的致痫灶定位和外科治疗方法以减少癫痫发作次数和程度。方法综合运用影像学、脑电图、PET—CT、脑功能皮层定位检查和偶极子定位以及磁共振融合等方法，对35例难治性癫痫患者进行病灶定位和外科手术治疗，并进行手术前后心理状况评估。结果随访评估疗效满意24例(68．6％)，显著改善5例(14．3％)，良好4例(1．4％)，较差2例(5.7％)。除1例巨大动静脉畸形术后有偏瘫和1例有计算障碍以外，无其他神经系统并发症，无死亡病例。结论综合应用影像学、电生理、核素检查和计算机图像融合技术，可以对大多数癫痫病灶的起源进行精确定位诊断，从而使难治性癫痫的外科治疗获得满意疗效。

Localization of the Epileptogenic Focus and Surgical Treatment in Refractory Epilepsy (35 Cases Report)

Objective To study the methods of precise localizations of epilepsy focus and surgical treatment of refractory epilepsy. Methods By the comprehensive application of the imaging examination, EEG, electrocorticogram, PET-CT and image fusion techniques, the epilepsy focus was precisely located,and the psychologic status was evaluated before and during operation in35 patients with refractory epilepsy treated surgically. Results The follow-up outcomes showed that satisfaction was in 24 patients (68.6%), significant improvements in 5 (14.3%), good in 4 (1.4%), poor in 2 (5.7%). Except one case of hemiplegia after arteriovenous malformation operation, and another dyscalculia, there were no serious complications and no death. Conclusion The development of imaging procedures, electrophysiology and computer fusion techniques, has simplified precise seizure localization. Furthermore, improved neurosurgical techniques incessantly have increasingly led to very good operative results for drug-resistant epilepsies.