顽固性额叶癫痫的手术治疗

目的 总结与分析顽固性额叶癫痫患者手术治疗的效果和经验。方法 回顾性分析2001年9月到2003年3月在我科接受手术治疗的66例顽固性额叶癫痫病例，统计患者的症状、检查及手术治疗情况，并总结手术体会。结果 手术行额叶癫痫病灶切除 多处软膜下横切(MST)12例。额极切除1例。额叶MST 选择性胼胝体切开 选择性海马杏仁核切除14例，额叶MST 选择性胼胝体切开30例，额叶MST 选择性海马杏仁核切除3例，额叶MST 选择性胼胝体切开 双侧直回内侧切除术2例，单纯MST4例。术后疗效满意49例(74．2％)，显著改善ll例(16．7％)，良好4例(6．1％)，无效2例(3．0％)。结论 顽固性额叶癫痫患者的特点是病情严重，手术效果好。

Surgical Treatment of Intractable Frontal Lobe Epilepsy

Objectives To analyze the curative effect of operation on intractable frontal lobe epilepsy(IFLE) and to introduce surgical experience in treating it. Method The clinical and imaging data of 66 patients with IFLE, who were surgically treated in our department from September, 2001 to March, 2003, were analyzed retrospectively. Results Of 66 patients with IFLE, 12 underwent resection of epileptogenic lesion and multiple subpial transection (MST), 14 frontal MST, selective corpus callosotomy and amygdalohippocampotomy, 30 frontal MST and selective corpus callosotomy, 3 frontal MST and selective amygdalohippocampotomy, 2 frontal MST, selective corpus callosotomy and resection of bilateral straight gyrus, 1 resection of frontal lobe and 4 MST only. Forty-nine (74.2%) patients were free from seizure, 11 were significantly improved in symptom, 4 had fair curative effect and 2 were unchanged. Conclusions The condition is severe and the curative effect of the operation is good in the patients with IFLE.