【作者】 王俊； 宋伟正； 王超； 熊彪云； 刘窗溪；

【Author】 WANG Jun,SONG Wei-zheng,WANG Chao,XIONG Yun-biao,LIU Cuang-xi~*,Department of neurosurgery GuiZhou provincial people’s hospital,Guiyang 550002,China

【机构】 Department of neurosurgery GuiZhou provincial people’s hospital；

【摘要】 目的探讨外伤性癫痫致痫灶的定位及手术效果。方法对2005年11月至2009年5月手术治疗的62例外伤性癫痫进行回顾性分析,男48例,女14例。年龄11～48岁,平均28.8岁。根据临床表现、影像学及电生理学检查结果进行术前定位59例;通过颅内电极置入定位3例。在ECoG监测下根据不同情况采用单纯软化灶切除术36例;软化灶及周围痫样放电部位一并切除15例;软化灶部分切除联合低功率皮层热灼术11例。结果术后随访6—33个月,按Engel分级,Ⅰ级32例,Ⅱ级17例,Ⅲ级9例,Ⅳ级4例,无Ⅴ级患者。结论 V-EEG是外伤性癫痫致痫灶术前定位的重要检查手段,在术中ECoG监测下采用不同术式进行手术,疗效满意。更多还原

【Abstract】 Objective To investigate the localization,microsurgical management of epileptogenic nidus of post-traumatic epilepsy.Methods The clinical materials in 62 cases with post-traumatic epilepsy were retrospectively analyzed.These patients were microsurgicallly treated between November 2005 to May 2009.The 62 patients,including 48 males and 14 females,ranged from 11 to 48 years old(average age of 28.8 years old). The epileptogenic nidus were localized by clinical manifestations,imaging and electrophysiological findings,in 59 cases,and by implanted intracranial electrodes in 3 cases.Resection of cerebral malacia in 36 cases,removing of both malacia and epileptogenic nidus in 15 cases,and partial resection of cerebral malacia combined with cortex thermocoagulation in 11 cases,were performed under electrocorticogram(ECoG) monitoring.Results With the 6 to 33 months follow-up,there were gradeⅠin 32 cases, gradeⅡin 17 cases,gradeⅢin 9 cases,gradeⅣin 4 cases according to Engel classification system.Conclusions V-EEG(visual electroencephalography) is an important method in pre-operative localization of epileptogenic nidus of post-traumatic epilepsy.ECoG monitoring and and proper microsurgical management are useful for an favorable outcome.更多还原