难治性癫痫伴脑内结构性病灶的手术治疗

目的探讨有脑内结构性病灶的难治性癫痫手术治疗的方法和疗效。方法对63例有结构性异常的难治性癫痫患者,术前行影像学和电生理检查定位,术中在皮质脑电图监测下手术。根据检测结果采用不同手术方式处理病灶和(或)致痫灶。结果63例患者中,单纯病灶切除27例,病灶切除加致痫皮层切除26例,病灶切除加皮层电灼5例,单纯致痫皮层切除3例,单纯致痫皮层电灼2例。其中41例(65%)术后癫痫完全消失,18例(28.6%)发作显著减少,4例(6.4%)发作减少。结论对伴有结构性病灶的难治性癫痫患者,应用皮层脑电图监测手术,切除结构性病灶和处理致痫灶,可取得很好效果。

Surgical Treatment of Intractable Epilepsy with Structural Lesions

Objective To investigate surgical methods and effectiveness of intractable epilepsy with structural lesions. Methods Electroencephalogram(EEG) and magnetic resonance imaging(MRI) were applied in 63 cases of intractable epilepsy with structural lesions before surgery.With cortical EEG monitoring during operation,the surgical ways were based on the results of MRI and EEG. Results In 63 cases,27 underwent lesionectomy,26 underwent lesionectomy plus cortexectomy,5 with lesionectomy plus cortex thermocoagulation, 3 with cortexectomy,and(2 with) cortex thermocoagulation.The effective rate was(93.6%.) Conclusion(The lesionectomy) must be taken with cortical EEG monitoring during operation in intractable epilepsy with structural lesions.The good effects were reached by surgical treatment for intractable epilepsy with structural lesions.