额叶癫痫的特点及手术治疗

目的 :分析额叶癫痫的临床特征、发作期及发作间期脑电图特点 ,探讨额叶癫痫手术治疗。方法 :应用视频脑电图对 9例额叶癫痫患者进行长程监测 ,并对其中 6例记录颅内脑电图。分析癫痫发作的临床表现及脑电图特点 ,定位致痫灶 ,行手术切除。结果 :额叶癫痫的发作特点为 :发作频繁而短暂 ,以睡眠期发作为主 ,常见过度运动 ,姿势性强直 ,发声等发作症状。发作期可见棘波节律 ,广泛低幅快活动 ,节律性慢波等特征性脑电活动。颅内电极记录可清晰显示异常脑电活动的发作起源及扩散情况 ,有助于定位致痫灶。手术切除病灶及致痫灶 ,效果满意。结论 :额叶癫痫是一组具有特征性的癫痫综合征 ,颅内电极记录有助于揭示其脑电活动变化。对于难治疗性额叶癫痫 ,准确定位致痫灶是手术成功的关键。

The characteristics and surgical treament of frontal lobe epiepsy

Objective: To evaluate clinical features, ictal and interictal EEG characteristics and surgery treatment outcome in patients with frontal lobe epilepsy. Methods: The clinical manifestions and EEG pattems of frontal lobe seizures and the epileptogenic zones were evaluated by long term video-EEG and chronic intracranial electrical recoding. The lesion and epileptogenic zone were resected simultaneously. Result: Frontal lobe seizures were frequent, brief and noctunal preponderance. The common ictal manifestations included hypermotor seizures or complex motor automatisms, tonic posturing, vocalization and so on. The ictal epileptic discharges might be of assistance for both their diagnoses and localization of epileptogenic zones. The outcome of removent of the lesion and epileptogenic zone was satisfactory. Conclusion: Ictal monitoring and intracranial electrical recording using video-EEG are very helpful for the diagnosis and surgery treatment of frontal lobe epilepsy.