摘要
目的总结以过度运动发作为主要表现的药物难治性癫癎的诊疗经验。方法回顾性分析25例药物难治性癫癎病人的临床资料,均以过度运动发作为主要表现。根据症状特点、MRI、头皮视频脑电图及颅内脑电图监测,综合定位致灶,并行手术切除。结果切除额叶致灶23例,切除前颞叶致灶2例。神经病理学检查显示：皮质发育不良（FCD）Ⅰ型8例,FCDⅡ型12例,节细胞胶质瘤1例,皮质微发育不良1例,灰质异位1例,胶质瘢痕1例,海马硬化1例。术后随访12~60个月,按Engel分级：Ⅰ级19例,Ⅱ级2例,Ⅲ级2例,Ⅳ级2例。结论以过度运动发作为特点的难治性癫癎病人,其致灶主要位于额叶,但也可位于额叶外的脑区,准确切除致癎灶后疗效满意。
Objective To summarize experience with the diagnosis,treatment strategies and outcomes in medically intractable epilepsy patients with hypermotor seizures.Methods The clinical data of 25 medically intractable epilepsy patients were analyzed retrospectively,the clinical manifestation of whom was seizures in hypermotor.The epileptogenic foci were localized based on the symptomatic features,MRI,scalp video electroencephalograph（VEEG） and intracranial EEG,and then resected.Results Epileptogenic foci were removed from the frontal lobe in 23 patients and from the anterior temporal lobe in 2.The neuropathological examination showed focal cortical dysplasia（FCD） Ⅰ in 8 patients,FCD Ⅱ in 12,ganglioglioma in 1,mild cortical dysplasia in 1,gray matter heterotopia in 1,glial scar in 1 and hippocampal sclerosis in 1.The follow-up period ranged from 12 to 60 months and the results were class Ⅰ in 19 patients,class Ⅱ in 2,class Ⅲ in 2 and class Ⅳ in 2 according to Engel classification.Conclusions The epileptogenic foci of medically intractable epilepsy patients with hypermotor seizures originate predominantly in the frontal lobe,and occasionally in the extrafrontal lobe.Satisfied surgical outcome could be achieved through accurate resection of epileptogenic foci.
出处
《中国微侵袭神经外科杂志》
CAS
北大核心
2011年第6期248-250,共3页
Chinese Journal of Minimally Invasive Neurosurgery
基金
北京市卫生局青年科学研究资助项目(编号:QN2009-001)
关键词
癫癎
难治性
过度运动发作
致癎灶
神经外科手术
epilepsy
refractory
hypermotor seizure
epileptogenic foci
neurosurgical procedures
