外伤性癫痫的X刀治疗

Treatment of the traumatic epilepsy in X knife

目的:探讨外伤性癫痫X刀治疗的疗效。方法:47例明确诊断的外伤性癫痫患者,全部检查脑电图(EEG)或动态脑电图(AEEG)、MRI,并在软化灶周围和(或)海马异常改变处检查磁共振波谱(MRS),观察NAA/(Cho+Cr)值,明确致痫灶,行X刀治疗。结果:47例患者,观察6～29个月,满意占57.4%,显著改善和良好占31.9%,较差和无改善占10.6%。结论:X刀治疗外伤性癫痫是一种安全、有效的治疗手段,利用MRS确定软化灶周围的致痫灶是可行的,治疗失败多与大面积软化灶、或剂量偏小以及影像学难以发现的致痫灶有关。

Objective：To investigate the clinic effect of traumatic epilepsy treated with X knife.Methods：47 patients which had been clearly examined to be traumatic epilepsy,all had been examined EEG or AEEG,MRI,and the MRS was examined where the encephalomalacia was around and （or） the hippocampal sclerosis was abnormally changed,observing the ratio of NAA/（Cho＋Cr） to make clear the epileptogenic part,and treated with the X knife.Results：47 patients which had been observed for 6 to 29 months,57.4% was satisfied,31.9% was remarkably improved and reach to be good,the ratio of relatively worse and no improvement was 10.6%.Conclusion：The treatment of the X knife for the traumatic epilepsy is a safe and effective treating measure,and defining the epilepsy focus around the encephalomalacia by using MRS is feasible,and the reason of the failure is mainly because the area of the encephalomalacia is big or the dosage is small and the epilepsy focus which is hard to find is also related.