难治性癫痫的外科治疗(附30例报告)

Surgical treatment of refractory epilepsy:30 cases report

目的探讨难治性癫痫的外科治疗方法并评价手术效果。方法对30例患者进行术前综合评估,确定致痫区的起源,配合术中神经电生理监测切除致痫区,手术后癫痫发作控制情况按Engel标准评判。结果随访12～27个月、平均18.3个月。Ⅰ级17例,Ⅱ级7例,Ⅲ级4例,Ⅳ级2例,未出现永久性神经功能障碍。结论外科手术是治疗难治性癫痫的有效方法,对致痫区的精确定位是关键。

Objective To explore the method of surgical treatment of refractory epilepsy and evaluate the effect of the surgery.Methods After comprehensive preoperative evaluation for the origin of epileptogenic zone,30 cases with refractory epilepsy accepted surgical treatment,electrocorticography was applied in the operations.The control situation of seizure was evaluated by Engel Standard.Results During 12-27 months follow-up,mean 18.3 months,17 cases had good results corresponding to Engel Ⅰ,and 7 cases Engel Ⅱ,4 cases Engel Ⅲ,2 cases Engel Ⅳ.No permanent complication was found.Conclusions Surgery was an effective method to treat refractory epilepsy.The key was to locate the epileptogenic zone.