胼胝体前部切开配合多软膜下横切术治疗顽固性全身性癫痫

Combined Anterior Corpus Callosotomy with Multiple Subpial Transection for the Treatment of Intractable Generalized Epilepsy

本文报告采用胼胝体前部切开配合主要痫灶多软膜下横切术治疗皮层广泛性痫灶的顽固性全身性癫痫２６例，一期手术２３例，均实施胼胝体前部切开，其中配合左额叶横切８例，右额叶横切９例，跨矢状窦开颅双侧额叶横切６例，分期手术３例，一期均实行单纯胼胝体前部切开术，二期行左额叶横切１例；右额叶横切２例，其中１例三期还施行了右顶枕叶横切。随访１～４年，发作消失１２例，占４６．２％，减少７５％以上１０例，占３８．５％

Atstract 26 cases of intractable generalized epilepsy were treated with combined anterior cor-pus callosotomy with multiple subpial transection (MST). 23 cases were treated in one stage oper-ation. That is: anterior corpus callosotomy combined with left frontal lobe MST in 8 cases, rightfrontal lobe MST in 9 cases, cross sagital sinus craniotomy bilateral frontal lobe MST in 6 cases.To do anteriol corpus callosotomy in first stage, than do left frontal lobe MST in second stage in 1case, right frontal lobe MST in 2 cases include 1 case of right parietaloccipital lobe MST in thirdstage. The follow up time was 1~4 years. Complete control of seizures was obtained in 12 cases(46. 2% ), seizures reduce more than 75% in 10 cases (38. 5% ), reduce 50~75% in 3 cases(11. 5), and no change in 1 case (3. 8% ). The total effective rate was 96. 2%. Significant effec-tive rate was 84.7%. No death and severe complication occurred. This results indicate that thecombination of copus callosotomy with MST can increase the effect of operation significantly.