外伤后癫痫的外科治疗

Surgical treatment for post-traumatic epilepsy

目的评价并总结外伤后癫痫(PTE)手术治疗的方法及治疗情况,为PTE的手术治疗提供经验。方法回顾性分析2008年1月至2010年1月在我院行开颅手术治疗的PTE病例42例,总结这些病例的术前定位技术、手术治疗方法以及0.5～2年期的随访情况。结果手术结果EngelⅠ级17例,Ⅱ级22例,Ⅲ级3例,IV级0例,术后出现暂时性轻度偏瘫28例,一过性动眼神经麻痹2例,暂时性运动性失语3例,无死亡病例。结论 PTE发作形式多为部分性发作,一般影像学检查可发现明确病理改变,致痫灶多位于其附近,药物难以控制病例行手术治疗效果较好。

Objective To evaluate the effect of surgical treatment of post-traumatic epilepsy （PTE） and provide surgical experiences for PTE.Methods A total of 42 cases who received surgical treatment in our department from January 2008 to January 2010 were analyzed retrospectively. The preoperative location techniques,surgical methods and the outcome during the follow-up of 0.5 year-2 years were summarized. Results Surgical outcomes included 17 cases of Engel class Ⅰ,22 cases of Engel class Ⅱ,3 cases of Engel class Ⅲ,and no case of Engel class Ⅳ. There were 28 cases of transient hemiplegia,2 cases of oculomotor paralysis,3 cases of motor aphasia and no dead case.Conclusion PTE is characterized by partial seizures. The potential seizure foci,which are usually near the cerebral lesions,can be detected by imaging examination. Surgical management is a good option for the intractable PTE.