CAJ | 학술논문

目的探讨外伤性癫痫的临床特点、致痫灶位置与脑软化灶的关系和手术疗效.方法沈阳军区总医院神经外科自2003年2月至2006年4月共手术治疗难治性外伤性癫痫患者13例,对其临床资料进行回顾性分析. 结果 8例患者致痫灶位于外伤软化灶周围(2～7 cm);5例为颞叶癫痫,其中4例为颞叶内侧型(3例受伤时年龄1.5～5岁,术后病理显示海马胶质细胞增生)、1例为颞叶外侧型.13例患者均在皮层电极监测下行手术治疗,4例同期行颅骨修补术.经2～5年随访,总手术有效率92.3%,优良率84.6%. 结论外伤性癫痫致痫灶常位于软化灶周围;小于5岁的重型颅脑损伤易导致海马硬化;难治性外伤性癫痫的手术疗效较好,一经诊断,应积极进行手术治疗.
목적 탐토외상성전간적림상특점、치간조위치여뇌연화조적관계화수술료효.방법 침양군구총의원신경외과자2003년2월지2006년4월공수술치료난치성외상성전간환자13례,대기림상자료진행회고성분석. 결과 8례환자치간조위우외상연화조주위(2～7 cm);5례위섭협전간,기중4례위섭협내측형(3례수상시년령1.5～5세,술후병리현시해마효질세포증생)、1례위섭협외측형.13례환자균재피층전겁감측하행수술치료,4례동기행로골수보술.경2～5년수방,총수술유효솔92.3%,우량솔84.6%. 결론 외상성전간치간조상위우연화조주위;소우5세적중형로뇌손상역도치해마경화;난치성외상성전간적수술료효교호,일경진단,응적겁진행수술치료.
Objective To investigate the clinical characteristics ofposttraumatic epilepsy, the correlation between epileptogenic foci and encephalomalacia, and the therapeutic effects of surgical intervention. Methods A retrospective analysis was performed among 13 patients with refractory post-traumatic epilepsy who received surgical intervention between February, 2003 and April, 2006. Results The first seizure attack occurred 0.5-13 years (mean 5.3 years) after craniocerebral injury in these patients. The epileptogenic loci were located around the encephalomalacia (ranging from 2 to 7 cm) in 8 patients, in the temporal lobe in 5 patients, in the medial temporal lobe in 4 patients (3 of whom sustained the injuries at 1.5-5 years of age with hippocampal glial proliferation shown by postoperative pathological examination), and in the neocortex of the temporal lobe in 1 case. All the patients underwent the operations under close monitoring of the cortical electroencephalogram, and 4 also received cranioplasty. The total effective rate of the surgery was 92.3% with an excellent outcome rate of 84.6% in the follow-up for 2-5 years. Conclusion The epileptogenic loci of posttraumatic epilpsy are usually adjacent to the encephalomalacia, and hippocampal sclerosis can be likely in patients with severe cerebral injury below 5 years of age. gefractory posttraumatic epilepsy often has favorable surgical outcome, and prompt surgery is suggested after the diagnosis.