论文部分内容阅读
目的探讨下丘脑错构瘤所致癫病灶的射频毁损治疗方法及疗效。方法回顾性分析3例下丘脑错构瘤所致难治性癫病人的临床资料,癫发作类型为痴笑、复杂部分性或者继发全面强直阵挛发作。MRI均诊断为左侧第三脑室内的下丘脑错构瘤(DelalandeⅡ型)。均采用立体定向病灶射频毁损技术治疗。1例病人于定向射频术后3个月,经脑室内镜下再次行病灶射频毁损。结果立体定向瘤内植入的深部电极均记录到样放电。2例局麻下射频毁损时,出现体温快速升高、血压升高、心动过速、出汗等症状,治疗停止后消失。术后均无严重并发症。术后随访1~7年,Engel分级:Ⅰ级2例,Ⅱ级1例。结论采用立体定向或脑室内镜下射频毁损技术治疗DelalandeⅡ型的下丘脑错构瘤癫,可达到精准、安全、有效的目的。
Objective To investigate the treatment of epileptic lesions caused by hypothalamic hamartoma and its therapeutic effect. Methods The clinical data of 3 patients with intractable epilepsy caused by hypothalamic hamartoma were retrospectively analyzed. The types of epileptic seizures were idiocy, complex partial or secondary complete tonic clonic seizures. MRI was diagnosed as left ventricular hypothalamic hamartoma (Delalande type II). Stereotactic lesions were treated with radio frequency destructive technology. One patient underwent directional radiofrequency 3 months after surgery, and the lesion was ruptured by intracerebral endoscopy again. Results The deep electrodes implanted in stereotactic tumors were all recorded as normal discharge. 2 cases of local anesthesia radiofrequency ablation, there was rapid rise in body temperature, high blood pressure, tachycardia, sweating and other symptoms disappear after treatment stopped. No serious complications after surgery. The patients were followed up for 1 to 7 years. The Engel grade was grade Ⅰ in 2 cases and grade Ⅱ in 1 case. Conclusion Stereotactic or endoscopic radiofrequency ablation can be used to treat Delalande type Ⅱ hypothalamic haemorrhagic epilepsy with accurate, safe and effective results.