晚期外伤性癫痫的手术治疗

总结 45例晚期外伤性癫痫患者的临床资料。全部病例均用手术治疗 ,术前进行详细评估 ,术中采用皮质脑电监测 ,手术方式包括致痫灶切除术、前颞叶切除术、前颞叶及海马切除术、皮质热灼术、胼胝体切开术。术后随访结果表明 ,患者的癫痫发作改善明显 ,按照Engel分级 ,Ⅰ级 2 3例 ,Ⅱ级 1 5例 ,Ⅲ级 7例 ,无Ⅳ级的患者。提示 :晚期外伤性癫痫患者如果经过系统的内科治疗无效 ,可以考虑外科治疗

Surgical Treatment of Late Posttraumatic Epilepsy

Clinical documents of forty-five late posttraumatic epilepsy cases were summarized.Surgical treatment was adopted in all of the cases.Detailed preoperative evaluation was done before the operation.ECoG monitoring was used during the operation.The surgical approaches included resection of the epileptogenic foci, anterior temporal lobectomy, anterior temporal lobectomy and hippocampectomy, bipolar coagulation of the cortex, corpus callosotomy.The follow-up results showed seizures of these patients improved evidently.According to Engel's grading, 23 cases were grade Ⅰ, 15 cases were grade Ⅱ, 7 cases were grade Ⅲ and no cases were grade Ⅳ.Surgical treatment is highly recommended in late posttraumatic epilepsy patients if systematic medical treatment fails.