【摘要】 目的:总结外伤性癫痫的临床特征及治疗效果。方法:根据患者临床特征与GCS分级、神经学检查及EEG、CT、MRI及ECT检查的诊断价值,分别予以分析。并确定致痫灶后手术治疗8例,手术中行皮层及深部脑电监测。结果:外伤性癫痫患者47例。临床主要表现有全身强直痉挛性发作、部分性发作、精神运动发作、失神发作。头皮脑电图显示47例中44例有与损伤部位或对冲部位相符的恒定局限性高波幅尖波、棘波和棘慢波,8例在皮层及深部脑电监测下切除病灶。31例已完全停止发作(其中术后6例),15例已明显好转,1例无明显改变。结论:外伤性癫痫的临床特点包括局灶性发作多见,癫痫发作形式多样和致痫灶在影像学改变附近,抗癫痫药物治疗及手术切除病灶能获良好效果。更多还原

【Abstract】 Objective:To summarize the clinical features of posttraumatic epilepsy and evaluate the outcome of its treatment.Methods:After the epileptogenic foci were identified by clinical feature,GCS,preoperational neurological examination,scalp EEG,CT,MRI and ECT,the operation was performed under monitoring of intraoperative electrocorticogram(ECoG)and deep EEG in 8 patients with posttraumatic epilepsy.Results:The age ranged from 8 to 52 years old in 47 patients with posttraumatic epilepsy.The clinical manifestations included generalized tonic-clonic seizures,absence seizures,the simple partial seizures and the complex partial seizures.The scalp EEG showed constant focal spike waves with high amplitude and sharp waves,and spike-slow waves near the contusion and contrecoup contusion in the 44 patients.There were not seizures in 31 patients(surgical treatment 6 cases),there was a great reduction in frequency of seizures in 15 and no change in 1.Conclusion:The results indicate that posttraumatic epilepsy is characterized by common partial seizures,varied forms of the seizures and epileptogenic foci near the cerebral contusions.The outcome of anti-epileptic drugs and surgical treatment of posttraumatic epilepsy is excellent.更多还原