以癫痫发作为首发症状的边缘系统病变的手术治疗

Surgical treatment of intractable epilepsy in patients with limbic system lesions

目的探讨边缘系统病变致顽固性癫痫手术治疗方法及效果。方法回顾性分析了我院自2008年1月份至2011年11月手术治疗的以癫痫发作为首发症状的边缘系统病变患者40例,经完善的术前评估、术中监测后,均行标准前颞叶切除+病灶切除。结果术中病变全切30例,部分切除10例。35例术后随访6～36个月(平均22个月),EngelⅠ级25例,Ⅱ级10例;5例失访。结论边缘系统病变可引起顽固性癫痫,手术切除病灶+癫痫灶安全,对癫痫控制效果好。

Objective To explore the operative method to treat the intractable epilepsy （IE）induced by limbic system lesions and the curative effect of surgery on it. Methods The clinical data of 40 patients with IE induced by the limbic system lesions, who underwent surgery in our hospital from January, 2008 to November, 2011, were analyzed retrospectively. The comprehensive assessment of epilepsy, epilepstogenic loci and intracranial lesions and intraoperative monitoring were performed in all the patients, who received the resections of anterior temporal lobes and limbic system lesions. Results The lesions were totally resected in 30 patients and partly in 10. Of 25 patients followed up from 6 to 36 months （mean, 22 months）, 25 belonged in Engel grade Ⅰ , and 5 in grade Ⅱ. The following up was lost in 5 patients. Conclusion The curative effect of the surgery including resections of the epileptogenic loci and intraeranial lesions on the intractable epilepsy induce by the limbic system lesions is good.