涉及中央区难治性癫(癎)的外科治疗

目的 探讨涉及中央区难治性癫(癎)的手术治疗.方法 3例患者术前除常规致癫(癎)灶评估外,还应用fMRI作皮质功能区定位.术中通过皮层EEG(ECoG)对致癫(癎)灶定位,通过皮层诱发电位(SEP)及皮质电刺激定位脑功能区,对位于功能区以外的致疒间灶行切除性手术,功能区内的致疒间灶行软脑膜下横行纤维切断术.结果 术后无神经功能障碍,术后3月,2例病人无癫(癎)发作,1例偶有部分性发作;术后8月,1例无发作,1例偶有部分性发作,1例减少75%发作. 结论术前功能区评估、术中电生理监测有助于保护皮质重要功能和提高手术癫(癎)控制率.

Surgical treatment of medically refractory epilepsy involving the central sulcus region

Objectsive To explore surgical treatment of refractory epilepsy involving in the central sulcus region. Method Epileptogenic focus must be assessed and fMRI was used to locate the functional area before surgery.During operation,epileptogenic focus was delineated by EEG/ECoG and functional area was located by direct cortex electrical stimulation.Epileptic focus was resected if not involved the functional area,and multiple subpial transactions was performed when involved functional area.Results No functional deficts were found after surgery,1case was seizure free,1 experienced occasional partial seizure,and 1 reduced 75% than before after 8 months.Conclusions Preoperative functional area mapping amd imtraoperative monitoring are important in functional protection amd improving seizure control rate.