脑皮层电图监测下显微手术治疗耐药性癫痫的效果

Effect of microsurgery in the treatment of drug-resistant epilepsy under the monitoring of electrocorticogram

目的探讨皮层脑电监测下显微手术治疗耐药性癫痫的效果。方法对2014年1月至2019年10月于河南省商丘市第一人民医院就诊的30例耐药性癫痫患者的临床资料进行分析。所有患者术中均在脑皮层电图监测下,应用显微外科技术切除致痫灶。术后第1天复查头颅CT,了解颅内有无出血及脑水肿等情况,观察有无癫痫发作及并发症,并监测生命体征。术后随访3个月至5年,按谭氏分类法评价手术效果。结果所有患者平均随访(2.78±1.46)年,其中术后发生同向性偏盲1例,占颞叶癫痫手术的6.25%(1/16),无手术死亡、颅内感染、颅内出血、偏瘫、失语等其他并发症发生。手术效果满意22例,显著改善5例,良好3例。结论在脑皮层电图监测下应用显微外科技术切除致痫灶是治疗药物难治性癫痫的有效方法。

Objective To investigate the effect of microsurgery in the treatment of drug-resistant epilepsy under the monitoring of electrocorticogram.Methods Clinical data of 30 patients with drug-resistant epilepsy admitted to the First People’s Hospital of Shangqiu,Henan Province from January 2014 to October 2019 were analyzed.In all patients,the lesions were removed by microsurgical technique under the monitoring of electroencephalogram.Head CT was reviewed on the first day after the operation,to understand the intracranial hemorrhage and cerebral edema,to observe the seizure and complications,and to monitor the vital signs.The postoperative follow-up was from three months to five years,and the results were evaluated by Tan’s classification.Results All the patients were followed up for an average of(2.78±1.46)years.One case of postoperative homohemianopsia occurred,accounting for 6.25%(1/16)of the patients undergoing temporal lobe epilepsy surgery.No surgical death,intracranial infection,intracranial hemorrhage,hemiplegia,aphasia,and other complications occurred.The results were satisfactory in 22 cases,significantly improved in five cases and good in three cases.Conclusion Microsurgical technique under electroencephalogram monitoring is an effective method to treat drug-resistant epilepsy.