CAJ | 학술논문

目的探讨惊吓性癫痫的临床、脑电图(EEG)特征及手术治疗效果.方法回顾性分析经抗癫痫药物或手术治疗的9例惊吓性癫痫的临床资料,总结发作症状学,头皮EEG,颅内EEG及头颅MRI特点,随访手术治疗效果.结果所有患者的多数发作均由惊吓诱发,仅2例存在少量自发发作.8例MRI发现结构性病变,头皮EEG显示多灶性或局灶性癫痫样放电.2例行颅内电极监测,对致痫灶进行了较精确的定位.5例手术治疗,3例大脑半球切除术,2例局部癫痫灶切除.术后随访6 -30个月(平均18.6个月),Engel Ⅰ级4例,EngelⅢ级1例.结论多数惊吓性癫痫患者存在脑的结构性损害,损害范围通常广泛,并均包含初级感觉运动区或辅助性感觉运动区.惊吓性癫痫多药物难治,手术治疗可取得较好的效果,明显改善患者的预后.
목적 탐토량하성전간적림상、뇌전도(EEG)특정급수술치료효과.방법 회고성분석경항전간약물혹수술치료적9례량하성전간적림상자료,총결발작증상학,두피EEG,로내EEG급두로MRI특점,수방수술치료효과.결과 소유환자적다수발작균유량하유발,부2례존재소량자발발작.8례MRI발현결구성병변,두피EEG현시다조성혹국조성전간양방전.2례행로내전겁감측,대치간조진행료교정학적정위.5례수술치료,3례대뇌반구절제술,2례국부전간조절제.술후수방6 -30개월(평균18.6개월),Engel Ⅰ급4례,EngelⅢ급1례.결론 다수량하성전간환자존재뇌적결구성손해,손해범위통상엄범,병균포함초급감각운동구혹보조성감각운동구.량하성전간다약물난치,수술치료가취득교호적효과,명현개선환자적예후.
Objective To study the clinical,scalp and intracranial electroencephalogram (EEG) characteristics of startle epilepsy,and its outcome of surgical treatment.Methods The clinical data of 9 patients with startle epilepsy who were treated in our hospital were reviewed retrospectively.Their scalp and intracranial EEG,and MRI were investigated.Results All of the patients were diagnosed as startle epilepsy,and most of seizures were provoked by sudden unexpected stimuli.MRI showed extensive lesions in 8 cases,scalp EEG showed mulifocality or focal epilepsic discharge in all.Intracranial electrodes monitoring were performed in 2 patients to locate the epileptogenic zone.Five patients were treated surgically,3 of them were operated with hemispherectomy,and 2 with focal cortex resection.During 6 -30 months follow up,the seizure outcome were Engel Ⅰ grade in 4,and Engel Ⅲ grade in 1.Conclusions Most of the patients with startle epilepsy has brain lesions involving the perisensorimotor or supplementary sensorimotor area,and were refractory.Resective surgery may get satisfactory outcome.