56例颅内海绵状血管瘤伴癫痫手术疗效分析

Efficacy of surgical treatment for cerebral cavernous malformation related epilepsy:report of 56 cases

目的 探讨颅内海绵状血管瘤伴癫痫的手术疗效。方法 回顾性分析2012年1月至2015年1月期间56例颅内海绵状血管瘤导致癫痫发作的患者,根据患者病史、动态-视频脑电图、影像学、功能区评估特点按照癫痫手术切除方式治疗,根据Engel评分,评价手术疗效。结果 13例患者术后早期出现发热、头痛并发症,3例早期轻偏瘫,均无远期并发症和后遗症发生。术后随访1~3年,43例患者Engel评分Ⅰ级,11例评分Ⅱ级,2例Ⅲ级。结论 颅内海绵状血管瘤伴有癫痫患者按照癫痫外科手术方式均可达到明显的控制癫痫发作效果。

Objective To evaluate the postoperative outcome of cerebral cavernous malformations （CCMs） related epilepsy. Methods Clinical data of 56 patients with CCMs-related epilepsy （CRE） admitted in our hospital from January 2012 to January 2015 were collected. According to the assessment results of the history of epilepsy, dynamic or video electroencephalogram （ EEG）, neuroimaging and functional area evaluation, the surgery was performed according to the approach of epilepsy surgery. All patients were followed up for 1 to 3 years after surgery. Engel classification was used to evaluate the surgery outcome. Results In the early postoperative period, 13 patients got fever or headache and 3 patients got hemiparesis. No complication or sequela was observed in the late postoperative period. After follow-up, 43 patients achieved Engel class Ⅰ , 11 patients class Ⅱ and 2 patients class Ⅲ. Conclusion Surgical treatment can achieve satisfying effect in the patients with CCMs-related epilepsy when it is performed according to the approach of epilepsy surgery.