颅内蛛网膜囊肿伴发癫痫致痫灶精确定位及外科治疗

目的研究蛛网膜囊肿伴发癫痫致痫病灶的精确定位及囊肿与致痫灶的关系以改进手术方法。方法对45例蛛网膜囊肿伴发癫痫的患者，在进行影像学和电生理学检查基础上，术中皮层脑电再次监测定位，对囊肿和癫痫灶同时切除。结果癫痫灶与囊肿的关系：位于蛛网膜囊肿内侧面19例；致痫灶位于蛛网膜囊肿边缘16例；致痫灶位于囊肿远隔部位（〉2cm）8例；检测不到致痫灶2例。并对全部病例进行随访。结论蛛网膜囊肿伴发癫痫患者其致痫灶和囊肿本身差异性大，单纯囊肿切除无法达到治疗癫痫的目的，术中皮层脑电监测下行蛛网膜囊肿切除术加致痫灶切除术才是治疗此类疾病的最佳方法。

Precise location of intracranial arachnoid cysts with epilepsy and its surgical treatment

Objective To research the relationship between intracranial arachnoid cysts and the lepileptogenic foci, and discuss how to improve surgical effeetion. Methods Take imaging and electrophysiological examinations of 45 intracranial arachnoid cyst patients with epilepsy, reposition them under intraoperative cortical electroencephalogram, resect the cyst and the epileptogenic loci simuhaneously. Results The relationship between the cyst and foci： The epileptogenic foci in the side of the cyst were found in 19 patients, at the edge of cyst in 16 patients, far from the cyst in 8 patients. 2 patients had not detected epileptogenic foci. All the patients were followed up. Conclusions Among the intracranial arachnoid cyst patients with epilepsy, some great diffreenees between the epileptogenic foci and the cyst exist. Simple cyst excision can not achieve the purpose of the treatment of epilepsy. Removal of cyst and the lesions under the EcoG monitoring at the same time is the best surgical management.