联合手术治疗顽固性癫痫

Combined operations in the treatment of complex intractable epilepsy

目的评价致痫灶切除+多处软脑膜下横纤维切断术(MST)联合使用的方法及临床效果。方法取稍大于致痫灶的头皮骨瓣开颅,脑皮层电极(ECoG)标出范围,手术切除致痫灶(非功能区)+MST(功能区)。结果术后随访5个月￣8年,控制癫痫发作总有效率为88%,其中优(Ⅰ级)47%,良(Ⅱ级)29%,可(Ⅲ级)12%,差(Ⅳ级)6%,无效(Ⅴ级)6%;无手术死亡及严重并发症。结论联合手术治疗顽固性癫痫,安全可靠,疗效肯定。

Objective To study the clinic effect of combined operations in the treatment of complex intractable epilepsy, including resection of the epileptogenious focus and MST. Methods The craniotomy was performed through bone flap whose area was a little larger than the focus. After marking the area with ECoG, the epileptogenious focus （the non-functional area） combined with MST （the functional area） was resected. Results For 5 months to 8 years follow-up, the effective rate was 88% totally, with level Ⅰ 47%, level Ⅱ29%, level Ⅲ 12%, level Ⅳ 6%, level Ⅴ （useless） 6%. No permanent complication and mortality occurred. Conclusion In the treatment of complex intractable epilepsy, the combined operations are effective for seizure control and as safe as regular seizure surgery.