双极电凝热灼联合病灶切除治疗涉及功能区癫的疗效观察

Observation of outcomes of bipolar electro-coagulation with lesionectomy for epilepsy involving the eloquent area

目的观察双极电凝热灼功能区致灶联合非功能区致灶切除治疗涉及功能区癫癎病人的疗效。方法回顾性分析40例致灶涉及功能区的癫癎病人的临床资料,行功能区致癎皮质电凝热灼及非功能区致癎灶切除。结果术后随访18-48个月,平均25个月。5例病人术后对侧有轻度的偏瘫,2例病人术后有轻度的感觉性失语,所有并发症均在1年内恢复。术后观察疗效：EngelⅠ级18例（45%）,EngelⅡ级8例（20%）,EngelⅢ级8例（20%）,EngelⅣ级6例（15%）。结论脑皮质电凝热灼术是治疗功能区癫癎有效且安全的方法,通过病灶切除联合脑皮质电凝热灼术治疗涉及功能区的癫癎,可取得良好的疗效。

Objective To observe the outcomes of bipolar electro-coagulation on the functional cortex （BCFC） plus lesionectomy in the non-functional cortex in patients with epilepsy involving eloquent areas. Methods Clinical data of 40 patients with epilepsy involving the eloquent area were analyzed retrospectively, who underwent lesionectomy in the non-functional cortex combined with BCFC. Results All the patients were followed-up for 18 to 48 months with a mean period of 25 months. The postoperative complications were mild contralateral hemiparalysis in 5 patients and mild sensory aphasia in 2, who recovered within 12 months. The outcomes were Engel class I in 18 patients （45%）, class Ⅱ in 8 （20%）, class Ⅲ in 8 （20%） and class Ⅳin 6 （15%）. Conclusions BCFC is a safe and effective method for treating epilepsy involving eloquent area. BCFC combined with lesionectomy can achieve good surgical outcome in patients with epilepsy involving eloquent cortex.