偶极子定位法手术治疗顽固性癫痫

Surgical treatment for intractable epilepsy guided by dipole localization

目的 探讨三维颅内癫痫病灶偶极子分析定位系统用于顽固性癫痫患者致痫灶定位以指导手术治疗的方式和效果。方法对1999年8月至2001年5月在作者所在医院住院治疗的240例顽固性癫痫患者运用偶极子三维颅内癫痫病灶定位系统进行顽固性癫痫致痫灶术前、术中定位,指导采用相应手术方式,并探讨其疗效及随访结果。结果 随访6个月以上者180例,疗效满意12例,显著改善36例,良好22例,差10例,总有效率为93.4%,显效率82.2%,未发现任何远期功能损害。结论偶极子三维颅内癫痫病灶定位系统是目前较为光进的癫痫病灶定位方法,以其指导手术,可明显增进手术效果,减少并发症。

Objective To evaluate the effect of surgical treaiment of inthectable epilepsy under the guidance of dipole localiza-tion (DL). Method From 1999 to 2001, 240 patients with intractable epilepsy received examination with electroencephalog-raphy and their epileptic foci identified by DL before the implementation of operations ranging from epileptogenic focus re-section to lobectomy, anterior corpus callosotomy or multiple subpial transection. Follow-up study was conducted in 180 ofthe patients for over 6 months. Results Satisfactory surgical result (seizure free) was achieved in 112 (62.2%) cases, with ob-vious improvement (scizure reduction by over 75%) in 36 (20%), improvement (seizure reduction by over 50%) in 22 (12.2%)and insignificant improvement in 10 (5.6%) cases. The total effective rate was 94%, with the significant effective rate of 82%.No long-term complications was found in these cases. Conclusion DL is an effective method for localizing epileptogenic focusin surgical treaghent of intractable epilepsy, which may improve the conventional outcome of inthectable epilepsy.