CAJ | 학술논문

目的：探索涉及中央前回的顽固性癫痫的外科治疗效果。方法癫痫发作起始位于或邻近中央前回的顽固性癫痫患者，开颅结合立体定向方法置入栅格状和深部电极。根据发作期颅内脑电图，电刺激，皮层诱发电位和高频颅内脑电图功能定位结果确定中央前回和致痫灶，镜下切除致痫灶。随访1年并回顾性分析23例患者致痫灶切除术后效果。结果癫痫治疗效果：EngelⅠ级19例；Engel Ⅱ级3例；Engel Ⅲ～Ⅳ级1例。所有患者致痫灶切除术后第1 d均出现单侧或单个肢体瘫痪，术后1年15例患者肌力恢复4级以上，无明显功能功能障碍，8例患者肌力3级及以下，遗留功能障碍。结论涉及中央前回的顽固性癫痫致痫灶切除术后多数患者可获得癫痫治愈而不遗留明显功能障碍。
목적：탐색섭급중앙전회적완고성전간적외과치료효과。방법전간발작기시위우혹린근중앙전회적완고성전간환자，개로결합입체정향방법치입책격상화심부전겁。근거발작기로내뇌전도，전자격，피층유발전위화고빈로내뇌전도공능정위결과학정중앙전회화치간조，경하절제치간조。수방1년병회고성분석23례환자치간조절제술후효과。결과전간치료효과：EngelⅠ급19례；Engel Ⅱ급3례；Engel Ⅲ～Ⅳ급1례。소유환자치간조절제술후제1 d균출현단측혹단개지체탄탄，술후1년15례환자기력회복4급이상，무명현공능공능장애，8례환자기력3급급이하，유류공능장애。결론섭급중앙전회적완고성전간치간조절제술후다수환자가획득전간치유이불유류명현공능장애。
Objective To explore the outcomes of epileptogenic zone resection of refractory epilepsy originating from areas related to precentral gyrus.Methods Patients with refractory epilepsy originating from areas related to precentral gyrus underwent intracranial electrodes implantation.Grid and depth electrodes were implanted through craniotomy associated by stereotactic technique.Precentral gyrus and epileptogenic zone resection were detected by intracranial EEG, electric stimulation, cortical evoked potentials and high frequency oscillation. Epileptogenic zone was resected under microscope .Results The outcome of epilepsy showed 19 in Engel Ⅰ,3 in Engel Ⅱand 1 in Engel Ⅲ-Ⅳ.All patients experienced unilateral or single limb hemiplegia on first postoperative day.15 cases, with muscle strength over grade 4, had no obvious dysfunction at 1 year after operation and 8 cases with muscle strength grade 3 or lower, had dysfucntion.Conclusion Most patients of refractory epilepsy originating from areas related to precentral gyrus were seizure free and had no obvious dysfunction after epileptogenic zone resection.