难治性外伤性癫痫的外科治疗42例分析

目的 探讨难治性外伤件癫痫的外科治疗方法及治疗效果。方法 回顾性分析42例接受外科手术并得到有效随访2年以上的外伤性癫痫病人的手术方式、手术效果。所有病人均行术前MRI检查，存偶极子定位下行手术治疗。结果 术后癫痫发作完全消失或仅有先兆31例，极少发作（≤3次／年）3例，手术效果满意率81．0％；发作明显改善（减少≥75％）5例，无明显改善（减少＜75％）3例，手术效果不满意率19．5％术后平均随访25.5月。结论 对难治性外伤件癫痫行偶极子定位下外科于术治疗可获得满意效果。

Surgical treatment of intractable post-traumatic epilepsy: retrospective analysis of 42 cases

Objective To discuss the surgical treatment of intractable post-traumatic epilepsy and its effect. Methods A total of 42 post-traumatic epilepsy patients, who underwent surgery under dipole localization combined with pre-operative MRI and accepted at least 2-year follow-up, were enrolled in this retrospective analysis on their surgical methods and effect. Results During the follow-up with a mean duration of 25.5 months, 31 of the patients were found to be completely seizure-free or with only aura (Class I), and 3 had only rare seizures (Class II, fewer than 3 seizures a year), satisfactory seizure control in 81.0% of the cases; obvious improvement was achieved in 5 (Class III, at least 75% seizure reduction), while 3 failed to respond to the surgical treatment (Class IV, less than 75% seizure reduction), unsatisfactory seizure control in 19.5%. Conclusion The surgical treatment of post-traumatic epilepsy with the help of dipole localization can result in a satisfactory clinical outcome.