手术治疗顽固性癫痫初探（25例临床分析）

Preliminary Study on Surgical Treatment of Intractable Epilepsy (Analysis of 25 Cases)

随访观察开颅手术治疗顽固性癫痫２５例，病程平均８．４年。术前平均服抗痫药治疗５．２年。皮质电图监测下行颞叶前份＋杏仁核切除１２例；颞叶外皮层痫灶切除３例；病灶＋周围皮层痫灶切除９例；胼胝前部切开１例。无明确病因者占６４％。痫灶光镜和电镜检查（１１例）结果符合癫痫的病理改变。随访结果，痊愈及显效者占８４％，总有效率９６％，无效４％。无手术死亡。

This paper reports the operative results of 25 cases of intractable epilepsy, The mean course of all cases was 8.4 years. All these patients took antiepileptics for 5.2 years on the average before operation. All the operations were performed with intra-operative electrocorticography surveilliance. Anterior temporal lobectomy and amygdalectomy were performed on 12 cases, resection of the cortical focus outside the temporal lobe on 3 cases, removal of the causative lesion and the epileptogenic focus on 9 cases, callsotomy on one case. There was no operative mortality. No causative lesion was found in 64%of these cases. But their epileptogenic focuses manifested epileptic pathological changes under light and electron microscope, Follow-up data showed execllent result: 84%of cases were cured or significantly improved: the total effective rate was 96%, Some questions about location of the focus and the mode of operation are analysed in this paper.