摘要
目的:总结难治性枕叶癫痫的外科治疗经验,分析该类病例的致痫病因。方法:本组19例经临床评估确诊为难治性枕叶癫痫者,其中13例行病灶周围扩大切除术,3例将病灶和颞叶后部、颞叶内侧结构一并切除,3例切除病灶后联合低功率电凝热灼术。结果:手术后病理诊断为脑组织软化坏死7例、局灶性皮质发育不良4例、低级别胶质瘤4例、海绵状血管瘤3例、颜面血管瘤病(Sturge-Weber综合征)1例。经过1年3个月至2年4个月的随访,Engel-I级17例,Engel-II级2例。手术后3例患者并发视野缺损。结论:难治性枕叶癫痫的致痫病变多为静止性病变或缓慢生长的低级别肿瘤,将病变和致痫灶一并切除可以有效控制癫痫发作。
Objective：To summarize the experience of surgical treatment for intractable occipital epilepsy and analyze epileptogenic pathogenies. Methods： 19 cases diagnosed as intractable occipital epilepsy by comprehensive evaluations underwent surgical treatments. Among of them, 13 cases were performed extended lesionectomy, 3 accepted lesionectomy plus temporalobectomy, and 3 received lesionectomy plus electrocoagulation in lower output power. Results：The postoperative pathological examinations showed that 7 cases were cerebronecrosis, 4 focal cortical dysplasia, 4 gliomas in lower grade, 3 cavernous malformations and 1 Sturge-Weber syndrome. According to Engel＇s classification criteria, 17 cases were grade Ⅰ, 2 were grade Ⅱ during the follow up period of 15 -24 months. There were three＇patients complaining visual defects after operation. Conclusions： Most intractable occipital epilepsy resulted from stationary lesions or tumors in lower grades. Resecting the lesions plus their epileptogenic zone may be a better choice for restraining the epileptic seizure effectively.
出处
《解剖与临床》
2008年第5期307-309,共3页
Anatomy and Clinics
