难治性癫痫的外科治疗 (附47例报道)

目的 研究难治性癫痫的致痫灶精确定位和外科治疗方法，以减少癫痫发作次数和程度，改善患者生存质量。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与磁共振融合等方法，对47例难治性癫痫患者进行癫痫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32例(68．1％)，显著改善7例(14．9％)，良好5例(10．6％)，较差2例(4．3％)，无改善1例(2．1％)。除1例巨大AVM术后有偏瘫，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，使难治性癫痫的外科治疗获得满意疗效。

Surgical treatment refractory epilepsy(47 cases report)

Objective To study the methods of exact 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,47 patients with refractory epilepsy were treated surgically.Results The follow-up outcomes showed that the satisfaction were 32 cases (68.1%),significant improvements were 7 cases (14.9%),good were 5 cases (10.6%),mild were 2 cases (4.3%),no change were 1(2.1%).Except one hemiplegia after AVM operation,and another dyscalculia occured,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 have increasingly led to very good operative results for drug-resistant epilepsies.