CAJ | 학술논문

目的探讨软化灶切除联合多处软膜下横切治疗局限性非外伤性脑软化灶相关癫痫的方法和效果.方法 28例非外伤性脑软化灶相关癫痫患者根据发作时症状、MRI、发作间期正电子发射计算机断层扫描(PET)和视频脑电图(VEEG)检查,确定致痫灶,进行全软化灶切除,软化灶周边辅以多处软膜下横切.术后随访1年以上,按Engel标准分级评价癫痫控制情况.结果术后1年,患者达到Engle Ⅰ级6例,Ⅱ级11例,Ⅲ级9例,Ⅳ级2例.软化灶局限、远离功能区、不伴有脑萎缩的患者癫痫控制率(Engle Ⅰ～Ⅱ)在80%以上,优于其他患者(P＜0.05).结论全软化灶切除联合多处软膜下横切可安全、有效地治疗非外伤性脑软化灶性癫痫,软化灶局限、远离功能区、不伴有脑萎缩的患者往往预后良好.
목적 탐토연화조절제연합다처연막하횡절치료국한성비외상성뇌연화조상관전간적방법 화효과.방법 28례비외상성뇌연화조상관전간환자근거발작시증상、MRI、발작간기정전자발사계산궤단층소묘(PET)화시빈뇌전도(VEEG)검사,학정치간조,진행전연화조절제,연화조주변보이다처연막하횡절.술후수방1년이상,안Engel표준분급평개전간공제정황.결과 술후1년,환자체도Engle Ⅰ급6례,Ⅱ급11례,Ⅲ급9례,Ⅳ급2례.연화조국한、원리공능구、불반유뇌위축적환자전간공제솔(Engle Ⅰ～Ⅱ)재80%이상,우우기타환자(P＜0.05).결론 전연화조절제연합다처연막하횡절가안전、유효지치료비외상성뇌연화조성전간,연화조국한、원리공능구、불반유뇌위축적환자왕왕예후량호.
Objective To analyze the strategy and outcome of complete lesion resection (CLR) and multiple subpial transaction (MST) for epilepsy caused by non - posttraumatic encephalomalacia.Methods 28 cases were treated with CLR and MST according to preoperative magnetic resonance image (MRI), positive (PET) and 128 - led long - term video EEG. They were followed up for more than 1 year,and their outcome was graded by Engel scales for analysis. Results Grade Ⅰ was observed in 6 cases and Grade Ⅱ in 11 cases, Grade Ⅲ in 9 cases and Grade Ⅳ in 2 cases. Satisfactory seizure control was found in patients with localized encephalomalacia, or far away from eloquent area, or without brain atrophy, more than 80%. Conclusion CLR combined with MST is effective and safe for epilepsy caused by nonposttraumatic encephalomalacia. And the cases with localized encephalomalacia, or far away from eloquent area, or without brain atrophy are likely to have a better outcome.