外伤性癫痫的外科治疗

目的探讨外伤性癫痫致痫灶的定位及手术治疗效果.方法：收治31 例外伤性癫痫患者,均行视频脑电图检查,其中29 例于术前通过临床表现、影像学及电生理学检查定位,2 例通过颅内电极定位.18 例行单纯软化灶切除,8 例行软化灶及周围痫样放电部位一并切除,5 例行软化灶部分切除联合低功率皮层热灼.结果：术后随访6-12 个月,按Engel 分级,Ⅰ级16 例,Ⅱ级8 例,Ⅲ级5 例,Ⅳ级2 例.结论：视频脑电图是外伤性癫痫致痫灶术前定位的重要检查手段,在皮层脑电图监测下采用合适的术式进行手术,疗效满意.

Objective:To discuss the localization, surgical treatment and its effect of epileptogenic zone of post-traumatic epilepsy. Methods:The clinical data of 31 post-traumatic epilepsy patients, who underwhent surgical treatment between Nov.2005 to May 2009, resection of both malacia and epileptogenic foci in 8,according to Engel classification system. Conclusions:V-EEG is an important method in pre-operative localization of epileptogenic focus of post-traumatic epilepsy.Favorable post-operative outcomes can be abtained with the help of ECo G monitoring.