CAJ | 학술논문

目的探讨累及中央区顽固性癫痫的外科治疗方法,并分析影响预后结果的相关因素.方法回顾性分析2008~2011年手术治疗的25例累及中央区的顽固性癫痫患者的临床资料.所有病例依情况分别结合颅内电极、皮层电刺激功能区描记、神经导航、术中唤醒和术中电生理监测等手段进行病灶、致痫区和功能区定位.结果3例术后出现短暂的对侧肢体肌力下降,2例术后对侧肢体肌力有回升,活动更灵活.术后随访12~24个月:EngelⅠ级16例,Ⅱ级5例,Ⅲ级1例,Ⅳ级3例.结论对累及中央区的顽固性癫痫患者,应在保障安全的前提下尽可能切除致痫灶和病变.颅内电极记录和术中唤醒等技术可用于颅内致痫灶的定位,在术中电生理监测下充分切除病灶及癫痫样放电区对控制癫痫发作效果良好.
목적탐토루급중앙구완고성전간적외과치료방법,병분석영향예후결과적상관인소.방법회고성분석2008~2011년수술치료적25례루급중앙구적완고성전간환자적림상자료.소유병례의정황분별결합로내전겁、피층전자격공능구묘기、신경도항、술중환성화술중전생리감측등수단진행병조、치간구화공능구정위.결과3례술후출현단잠적대측지체기력하강,2례술후대측지체기력유회승,활동경령활.술후수방12~24개월:EngelⅠ급16례,Ⅱ급5례,Ⅲ급1례,Ⅳ급3례.결론대루급중앙구적완고성전간환자,응재보장안전적전제하진가능절제치간조화병변.로내전겁기록화술중환성등기술가용우로내치간조적정위,재술중전생리감측하충분절제병조급전간양방전구대공제전간발작효과량호.
Objective To explore surgical treatment of the intractable epilepsy involving perirolandic area (IEIPA) and the factors related to the curative effect. Methods The clinical data of 25 patients with IEIPA treated by surgery from 2008 to 2011 were analyzed retrospectively. The intracerebral lesions, epileptogenic foci and cerebral functional area were located by the various techniques including intracranial electrodes implantation, cortical electrical stimulation, neuronavigation, intraoperative wake-up procedure, and intraoperative EEG monitoring. Results The muscle power of the limbs contralateral to the lesions decrease in 3 patients and increase in 2 patients after the surgery. The following up from 12 to 24 months showed that of 25 patients, 16 received Engel grade Ⅰ outcomes, 5 gradeⅡ, 1 grade Ⅲ and 3 grade Ⅳ. Conclusions The epileptogenic foci and intracranial lesions should be removed as much as possible by surgery under the prerequisite for the patients’safety in the patients with IEIPA. Intraoperative wake-up procedure and intracranial electrodes implantation may be applied to the location of the epileptogenic foci. The curative effect of surgery on IEIPA is good.