多种手术方法联合治疗创伤后癫痫

目的评价多种手术方法联合使用治疗创伤后癫痫的效果。方法21例患者根据术前致痫灶的初步定位和术中皮层脑电及深部电极的监测结果，分别采用以下5种不同的术式：(1)瘢痕及周围皮层切除7例；(2)瘢痕及周围皮层切除 多软膜下横切术(MST)8例；(3)前颞叶、杏仁核-海马切除4例；(4)神经导航下选择性杏仁核-海马切除1例；(5)胼胝体前部切开 MST 皮层热灼1例。结果术后随访3个月～10年，疗效满意9例(43％)，显著改善7例(33％)，良好3例(14％)，效果较差1例(5％)，无改善1例(5％)。术后无死亡病例，有8例出现暂时性对侧手指精细运动功能障碍，但均在4周内恢复正常。结论多种手术方法联合治疗创伤后癫痫安全有效。

Combined operations for post-traumatic epilepsy

Objective To evaluate the surgical outcomes of the combined operations for post-traumatic epilepsy during one surgery. Methods According to the preoperative tentative location of epileptogenic focus and the monitoring results of intraoperative electrocorticography and depth electrodes, 21 seizure patients were treated with various surgeries,including epileptogenic focus resection in seven patients, epileptogenic focus resection combined with multiple subpial transection (MST) in eight,anterior temporal lobectomy combined with amygdalo-hippocampectomy in four,selective amygdalo-hippocampectomy under neuronavigation in one and anterior callosotomy combined with MST and bipolar coagulation on functional cortexes in one. Results All patients were followed up for from three months to 10 years postoperatively. The results showed satisfactory outcome in nine patients (43%), marked improvement in seven (33%),improvement in three (14%),slight improvement in one (5%) and little improvement in one (5%).No death occurred during the procedure. Eight patients had temporary functional disturbance but recovered within four weeks after surgery. Conclusions The combined operations are effective for treatment of post-traumatic epilepsy.