CAJ | 학술논문

目的初步探讨后象限离断术在颞顶枕叶难治性癫痫治疗中的作用和效果.方法回顾性分析天津市环湖医院功能神经外科自2012年2月至2013年10月采取后象限离断术治疗的3例后象限难治性癫痫患者的临床表现、神经电生理及影像学检查结果及随访情况.结果 3例患者临床发作形式分别为简单部分发作、部分发作继发全面发作及全面强直阵挛发作,MRI检查显示病理改变分别为脑穿通畸形、脑白质发育不良及灰质异位.患者于全麻下行右侧后象限离断术.3例患者分别随访32、12、29个月,其中Engel Ⅰ级2例、EngelⅡ级1例,无长期神经功能障碍或死亡病例.结论后象限离断术可获得与切除术相似的治疗效果,是治疗局限于一侧后象限的难治性癫痫的有效方法.
목적 초보탐토후상한리단술재섭정침협난치성전간치료중적작용화효과.방법 회고성분석천진시배호의원공능신경외과자2012년2월지2013년10월채취후상한리단술치료적3례후상한난치성전간환자적림상표현、신경전생리급영상학검사결과급수방정황.결과 3례환자림상발작형식분별위간단부분발작、부분발작계발전면발작급전면강직진련발작,MRI검사현시병리개변분별위뇌천통기형、뇌백질발육불량급회질이위.환자우전마하행우측후상한리단술.3례환자분별수방32、12、29개월,기중Engel Ⅰ급2례、EngelⅡ급1례,무장기신경공능장애혹사망병례.결론 후상한리단술가획득여절제술상사적치료효과,시치료국한우일측후상한적난치성전간적유효방법.
Objective To discuss the effect of posterior quadrant disconnection surgery on temporoparietooccipital intractable epilepsy.Methods A retrospective review of clinical,neuropsychological,EEG,imaging and histopathological data of 3 patients with intractable epilepsy,admitted to and underwent posterior quadrant disconnection surgery in our hospital from February 2012 to October 2013,was performed.Results The clinical manifestations of 3 patients were simple partial seizures generalized seizures secondary to partial seizures and generalized tonic clonic seizures.MRI examination showed that 3 patients were porencephaly,white matter dysplasia,and gray matter heterotopia.Patients were treated with right posterior quadrant disconnection surgery after general anesthesia.Follow up of 32,12 and 29 months was respectively performed in these 3 patients.The seizure control result after surgery was Engel Ⅰ in 2 patients and Engel Ⅱ in one patient.There was no new prolonged neurological deficit or death.Conclusion Posterior quadrant disconnection surgery is an effective method for posterior quadrant intractable epilepsy,which results in similar excellent early seizure control as hemispherectomy.