顽固性癫癎的外科联合手术治疗

目的探讨联合手术治疗顽固性癫癎的方法和临床疗效。方法对45例顽固性癫癎患者行联合手术治疗。手术方式:多处软脑膜下横切术(multiplesubpialtransection,MST)+致癎病灶切除+胼胝体前部切开术3例;MST+胼胝体前部切开术11例;MST+致癎病灶切除19例;MST+立体定向杏仁核海马毁损术12例。术中进行皮层电极及深部电极监测。结果术中进行皮层电极检测定位更精确。患者术后随访3-28个月,发作完全控制17例(37.78%),显著改善24例(53.33%),良好2例(4.44%),效差2例(4.44%),术后神经功能均保存完好。结论联合手术治疗顽固性癫癎是一种安全有效的方法。

Combined operations for treatment of intractable epilepsy

Objective To investigate the management and clinical effect of the combined operations for the intractable epilepsy. Methods 45 patients with intractable epilepsy were performed by combined operations.The operative methods including multiple subpial transection(MST) + epileptogenic lesion resection + anterior corpus callosotomy in 3 cases; MST + anterior corpus callosotomy in 11 cases; MST + epileptogenic lesion resection in 19 cases; MST + amyg-dalohippocampotomy in 12 cases. The operations were monitored by electrocorticography and depth electrode recording. RusultS Electrocorticograghy is of benefit to accurate location for epileptogenic focus during the operations. After operation, all patients were followed up from 3 to 28 months. The therapeutic results were seizure free in 17 cases (37.78%), marked improvement in 24 cases(53.33% ),improvement in 2 cases(4.44% ) and non-improvement in 2 cases(4.44% ) . All patients had no post-operative neurologic disorder. Conclusion Combined operation is a sale and effective management for intractable epilepsy.