综合应用定位技术和外科方法治疗顽固性癫痫

目的：研究顽固性癫痫的致痫灶精确定位和外科治疗方法。方法：对185例顽固性癫痫患综合应用三维痫灶精确定位诊疗计划系统及影像学检查进行术前、术中致痫灶三维精确定位，采用癫痫外科综合治疗方案（手术治疗、介入放射治疗、定向放射治疗等）毁损致痫灶、阻断致痫网，以治疗顽固性癫痫。结果：术中64导皮层电极及8导深部电极检测证实该定位系统定位准确可靠。必要的影像学检查有助于痫灶定性定位诊断及治疗方案设计。随访疗效评估显效率达到87．0％，总有效率达到94．6％，术后神经功能保持良好，无明显后遗症。结论：综合应用三维痫灶精确定位诊疗计划系统和影像学检查对痫灶进行定位以及采取癫痫外科综合治疗方式是治疗顽固性癫痫的较好方法。

Comprehensive application of location techniques and surgical methods in treatment of refractory epilepsy

Objective To study the methods of exact localization of epilepsy focus and surgical treatment of refractory epilepsy. Methods The epilepsy focus was precisely located by the system of diagnosis and treatment of three dimensional epilepsy focus localization and imaging examination in 185 cases of refractory epilepsy before and during operation. The epilepsy focus and epilepsy net were destroyed by comprehensive surgical treatment programs, including operation, interventional therapy and stereotactic radiosurgery. Results The accurate location of the epilepsy focus by this system was confirmed by examination of intraoperative 64-channel cortex electrodes and 8-channel deep electrodes. The imaging examination was helpful to diagnose the epilepsy focus and to design the treatment programs. The follow-up outcomes showed that the apparent efficacy rate was 87.0% , total efficacy rate was 94. l%and the patients'nervous function kept well without serious complications. Conclusion The comprehensive application of the system of diagnosis and treatment of three dimensional epilepsy focus localization, imaging examination and surgical treatment programs are better methods to treat the refractory epilepsy.