改良式大脑半球切除术治疗难治性癫痫(附4例分析)

Modified hemispherectomy for treatment-resistant epilepsy(report of 4 cases)

目的探讨改良式大脑半球切除术治疗半球病变导致的难治性癫痫的手术疗效。方法回顾性分析我科自2013年11月至2014年8月采用改良式大脑半球切除手术治疗4例一侧大脑半球病损所致的难治性癫痫的临床资料和随访结果。术前4例患者均完善头颅MRI、长程视频脑电图监测采集发作2次以上、脑PET-CT和神经心理功能测定等综合评估。结果治疗效果按Engel分级,I级2例,II级2例;前3例患者术后肢体及神经心理功能较术前无加重,第4例患者术后神经心理功能较术前无加重,肢体障碍加重,但在恢复期。结论改良式大脑半球切除术是治疗半球病变导致的难治性癫痫的一种有效方法。

Objective To explore the effect of Modified hemispherectomy for treatmentresistant epilepsy.Methods The clinical data of 4patients,who underwent hemispherectomy in our hosipital from 2013 to 2014,were analyzed retrospectively.The preoperative examinations included MRI,long-term video-EEG,PET-CT and neuropsychological assessment in all patients.Results Of 4patients,2had Engel grade I therapeutic outcome and 2grade II.3patients were not significant exacerbation of their limbs and neuropshychology.1patient was not significant exacerbation of neuropshychology,but limb disorders increase in recovery.Conclusion Modified hemispherectomy for hemispherd lesions lends to an effective method of refractory epilepsy.