扩大胼胝体离断术治疗难治性癫痫

Extended one-stage callosotomy for the patients with the intractable epilepsy

目的探讨扩大胼胝体离断术治疗难治性癫痫的手术疗效和并发症的发生。方法回顾性分析58例扩大胼胝体离断术患者,分析术后的急慢性并发症和手术对癫痫发作的控制。结果术后随访13～48个月,所有患者术后仍然继续术前抗癫痫药物治疗,6.9%(4例)的患者术后发作消失,术后发作频率减少大于75%的患者为55.2%(32例),29.3%(17例)的患者发作频率减少50%以上,8.6%(5例)的患者无明显改善。51例患者术后发生缄默症状,47例在术后2周内恢复,4例3周后恢复;11例出现右侧肢体轻偏瘫,均在2周内症状消失;6例术后3～6天出现小便失禁,均在2周内恢复;未见长期并发症患者。结论对于癫痫灶定位困难的难治性癫痫患者,扩大胼胝体离断术能够较好的缓解患者的发作,尽管急性并发症发生率较高,但通常恢复良好,远期并发症发生率低,是一种有效和安全的手术。

Objective To retrospectively analyze the seizure control and complications after extended one-stage callosotmy for the patients with the intractable epilepsy. Methods There were 58 patients with intractable epilepsy who underwent extended on-stage callosotomies. The seizure control and complications after extended one-stage callosotmy were analyzed. Results 13-48 months after the surgery, 6.9% of patients got seizure free; 84. 5% of patients got improvement; 8.6 % of patients show no improvement. 51 patients developed mutisms after surgery and recoved in 1 -3 weeks; 11 patients developed right--side hemiplegia and recovered in 2 weeks. 6 patients developed urinary incontinence and recovered in 2 weeks. Conclusion Extended one-stage callosotomy is effective and safe for the patient with the intractable epilepsy.