【摘要】 目的额叶癫痫致痫灶切除术后有效率低于颞叶癫痫,对于术后无效或复发病例目前仍缺乏有效的治疗方法,探讨采用完全额叶孤立术解决这一问题的可行性。方法利用尸头进行前额叶相关术中显微解剖研究,指出前额叶切开的解剖标志,并对1例致痫灶切除术后无效的额叶癫痫患者施行额叶孤立术,为保证前额叶彻底孤立,在额叶切开的同时离断前连合和胼胝体前部。结果术后随访16个月,虽然病侧脑电图仍偶有类尖波发放,但临床发作完全停止。结论前额叶孤立术是治疗额叶癫痫的有效方法,手术的关键是将目标区域即前额叶与脑的其他区域完全离断,切开前连合和胼胝体前部保证这一目的的实现。更多还原

【Abstract】 Objective The surgical efficiency of frontal lobe epilepsy cases after epileptogenic focal resection were low than that of medial temporal epilepsy ones,furthermore,and there were no practical surgical solution for recurrent cases and invalid cases after resectable surgery.Our study aims at exploring the feasibility of total prefrontal isolation technique to solve this problem.Method We utilized the head of postmortem to study the micro-dissection of prefrontal lobe and indicated the anatomical landmark of the dissection of prefrontal lobe;Additionally,we performed an operation of total prefrontal lobe isolation for one case who had has a invalid surgery of epileptic focus resection.In order to ensure the completeness of prefrontal isolation operation,we broke the anterior commissure and the forepart of corpus callosum at the same time of the dissection of frontal lobe.Results In a 16-month postoperative follow-up,the seizure ceased completely,although still few sharp-like waves sometimes could be seen in the operative area.Conclusion The prefrontal isolation operation is an effective surgical solution in the treatment of frontal lobe epilepsy.The key to this procedure is the complete dissection of prefrontal lobe and other brain areas.And the cutoff of anterior commissure and forepart of corpus callosum promises the successful procedure.更多还原