立体定向病灶切除联合皮层热灼术治疗起源于中央区的癫

目的探讨立体定向病灶切除联合皮层热灼术治疗起源于中央区的癫(癎)的疗效.方法对27例以癫(癎)为首发表现的起源于中央区的癫(癎)病人采用立体定向开颅手术,切除病灶前先行皮层电极描记,确定癫(癎)波的范围,然后在显微镜下切除病灶,再次描记确定残余的癫(癎)波的位置,并使用皮层热灼术进行皮层热灼,直到癫(癎)波消失为止.结果27例病人中胶质瘤13例,脑囊虫病7例,脑膜瘤3例,皮层发育不全2例,海绵状血管瘤1例,炎症1例.手术中在切除病灶前使用皮层电极描记出癫(癎)波,病灶切除后在病灶周围仍残余有癫(癎)波,使用皮层热灼术热灼后癫波消失.27例病人手术后25例未再有癫(癎)发作,2例手术后一周内有癫(癎)发作一次,以后未再有癫(癎)发作.26例病人未出现神经功能损害症状加重,一例短期内出现偏瘫加重,经过对症处理后好转.结论立体定向病灶切除联合皮层热灼术治疗起源于中央区的癫(癎)是一种侵袭性小、疗效佳的手术方法.

Stereotactic-resectioncombined with cortex thermocoagulation for treatment of lesional epilepsy on centralregion

Objective To evaluate the value of stereotactic-resection to the lesions combined with cortex thermocoagu-lation for the treatment of lesional epilepsy on central region. Methods Stereotactic-resection combined with cortex thermo-coagulation for the treatment of lesional epilepsy on central region was used in 27 patients. The ECoG was used to detect the spike wave.Cortex thermocoagulation was used after stereotactic-resection of the lesions when the ECoG also record the spike wave on central region.Rusults Of 27 cases,there were 13 cases of glioma,7 cerebral cysticerosis,3 meningioma,2 dys- trophia, 1 cavernoma and 1 inflammation. After operation, the seizure was disappeared in 25 cases, and 2 cases had a mild seizure in one week. The damage of neurofunction did not aggravate in 26 cases, and 1 case had a transient hemiparesis. Conclusion Stereotactic-resection combined with cortex thermocoagulation for the treatment of lesional epilepsy on central region is a mini-invasive and valuable method.