149例顽固性癫痫皮质脑电图监测下痫灶切除手术的临床分析

Clinical Analysis of Epileptic Surgery under Electrocorticogram Monitoring in 149 Patients with Intractable Epilepsy

目的总结皮质脑电图监测下痫灶切除手术治疗顽固性癫痫的临床疗效.方法回顾性分析149例经皮质脑电图监测下痫灶切除手术治疗的149例顽固性癫痫患者的临床资料,并结合随访资料讨论痫灶定位、手术要领、适应症及疗效判定标准.结果随访11个月～21年,按Engle标准对术后疗效进行判断,I级31.5%,Ⅱ级25.5%,Ⅲ级28.2%,Ⅳ级14.8%.手术总有效率为85.2%,无手术死亡及严重并发症发生.结论皮质脑电图监测下痫灶切除手术安全、有效,可为治疗顽固性癫痫的首选方案.

Objective To explore the curative effect of epileptic surgery under electrocorticogram(ECoG)monitoring in the patients with intractable epilepsy.Methods The clinical data of149patients with intractable epilepsy who underwent epileptic surgery under ECoG monitoring were summarized and analyzed retrospectively.The epileptic foci localization,surgical essentials and indica-tions,and the assessment of the the curative effect were discussed in combination with the follow-up data.Results According to Engel standard of the curative effect,grade1accounted for31.5%of149patients with epilepsy undergoing epileptic surgery,grade225.5%,grade328.2%and grade414.8%.The total effective rate was85.2%.No surgical complications happened and no patients died from the surgery.Conclusion The epileptic surgery under ECoG monitoring is safe and effective,and should be the prior strategy in the patients with intractable epilepsy.