皮层脑电图描记下致痫灶切除术治疗难治性癫痫的临床及病理学研究

The clinic and pathology study of refractory epilepsy using operation to resect the epileptogenic foci with electrocorticography

目的 研究皮层脑电图描记下致痫灶切除治疗难治性癫痫的临床及其病理学改变。方法 采用皮层脑电图描记下对 35例难治性癫痫的致痫灶进行切除 ,同时对术中所切除的致痫灶组织送病理检查。结果 35例癫痫经术后综合疗效评定 :1年内癫痫发作消失者 12例 ;显进 12例 ;进步 8例 ;无变化 2例 ;失随访 1例。术后病理报告 :肿瘤 10例 ;血管畸形 5例 ;囊肿 6例 ;炎性肉牙肿 3例 ;外伤性软化灶 3例。余为脑组织神经变性伴胶质细胞增生。结论 致痫灶切除治疗难治性癫痫的效果肯定 ,致痫灶组织均存在结构性病理改变。

Objective To study the clinic and pathologic change of refractory epilepsy using operation to resect the epileptogenic foci with electrocorticography.Methods 35 cases with efractory epilepsy were operated on by resections of the epileptogenic foci with electrocorticography.,and the tissues that were cut off were done the pathologic inspections.Results The general assessment after operation showed:the epilepsy disappeared in 12 cases within 1 year,marked improvement in 12,improvement in 8,no improvement in 2,no follow-up in 1.The pathologic reports after operations showed:tumour in 10,blood vessel malformation in 5, intracranial cyst in 6,phlogistic granuloca in 3,malacoplakia after injury in 3.The others were nerve degeneration of brain,spongiocyte hyperplasia,hemosiderosis,lymphatic infiltration and so on,and no case had no change.Conclusions The resection of the epileptogenic foci has definite effect to treat tefractory epilepsy,and all the epileptogenices have pathologic changes.