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精神障碍性癫痫是指智商(IQ)18岁前低于70分的癫痫发作。过去对该种癫痫是否外科治疗认识不一。随着癫痫诊治技术的进步,该病的外科治疗取得了良好效果。外科治疗方法有颞叶切除:治疗有效率达92％;颞叶外癫痫外科:致痫区+功能性皮质切除、额叶周边切除相当成功;多处软膜下横断:适用于功能性皮质致痫区;胼胝体切开:适用于失张力性发作、药物难治性发作、威胁生命的大发作;大脑半球切除:适用于一侧大脑半球萎缩、婴幼儿偏瘫和癫痫大发作,治疗后85％的病人发作停止。研究表明:术前IQ不能决定外科治疗癫痫的成败;低IQ病人致痫灶切除术后周边产生广泛致痫区,术后癫痫易复发;精神障碍是多因素的,该种病人不应列为手术禁忌症;外科治疗不仅使癫痫发作减少,同时也使脑功能恢复,精神障碍不同程度缓解。
Mental disorder Epilepsy refers to the seizure of IQ below 70 before 18 years of age. In the past on the surgical treatment of epilepsy different understanding. With the progress of diagnosis and treatment of epilepsy, surgical treatment of the disease has achieved good results. Surgical treatment of temporal lobe resection: the treatment of effective rate of 92%; temporal lobe epilepsy surgery: epileptogenic zone + functional cortical resection, the frontal lobe resection quite successful; multiple transection: suitable for functional cortical Epileptogenic zone; corpus callosum incision: apply to the onset of stress-induced seizures, drug-refractory attacks, life-threatening attacks; hemispherectomy: applicable to the hemisphere side of the brain atrophy, infantile hemiplegia and epilepsy seizures, 85% The patient’s seizures stopped. Studies have shown that: preoperative IQ can not determine the success or failure of surgical treatment of epilepsy; low IQ patients after epileptogenic resection of peripheral epilepsy produced a wide range of peripheral epilepsy prone to relapse; mental disorders are multifactorial, such patients should not be classified as Surgery contraindications; surgical treatment not only reduces seizures, but also to restore brain function, mental disorders alleviate to varying degrees.