大脑半球切除术治疗偏侧惊厥-偏瘫-癫痫综合征的疗效分析

Curative effect of hemispherectomy on hemiconvulsion-hemiplegia-epilepsy syndrome (report of 7 cases)

目的分析大脑半球切除术对偏侧惊厥-偏瘫-癫痫(HHE)综合征的手术疗效。方法回顾性分析2008～2010年收治的7例HHE患者的临床资料。对7例患者均进行头颅MRI检查、长程视频脑电图监测、功能MRI功能区评估、脑干诱发电位、视力视野检查和神经心理功能测定综合评估。手术方式包括Adam改良式大脑半球切除术6例,多脑叶切除+胼胝体切开术1例。结果治疗效果按Engel分级,Ⅰ级5例,Ⅲ级2例;患者肢体及神经心理功能均得到改善。结论大脑半球切除术可有效减少HHE患者癫痫的发作,同时能改善患者的肢体运动及神经心理功能。

Objective To analyze the curntive effect of hemispherectomy on hemiconvulsion-hemiplegia-epilepsy （HHE） syndrome. Methods The clinical data of 7 patients with HHE syndrome, who underwent hemispherectomy in our hospital from 2008 to 2010, were analyzed retrospectivel~（： The preoperative examinations included MRI, long-term video-EEG, functional MRI, brain stem evoked potentials, visual power and field examinations and neuropsyehological assessment in all the patients. Adam improved hemispherectomy was performed in 6 patients and subtotal hemispherectomy and corpus callosotomy were performed in 1 patient. Results Of 7 patients with HHE, 5 had Engel grade Ⅰ therapeutic outcome and 2 grade Ⅱ. All the patients were improved in the functions of their limbs and neuropsychology. Conclusions The seizure can be effectively controlled and the ＇limbs and neuropsyehological functions may be improved by the hemispherectomy in the patients with HHE syndrome.