论文部分内容阅读
目的探讨中央区纵裂癫的诊治经验。方法回顾性分析6例癫病人的临床资料,术前均进行评估,包括临床表现、MRI、视频脑电图(VEEG)、加密电极、埋藏电极和(或)皮质脑电图(ECoG)、脑磁图(MEG)检查,确诊为中央区纵裂癫。通过皮质电刺激、立体定向引导、术中唤醒等方法,明确致灶、功能区的范围及相互位置关系,在皮质脑电图监测下行显微手术切除致灶。结果病变手术全切除3例,大部分切除3例。术后均无出血、感染等并发症出现,无麻醉意外发生。术后病理结果为:胶质增生1例,局灶性皮质发育不良Ⅱa1例、Ⅱb2例,脂肪瘤1例,海绵状血管瘤1例。随访6例,时间13～23个月,根据Engel分级:Ⅰ级5例,Ⅱ级1例。结论中央区纵裂癫表现特异,确诊后在精确定位致灶、功能区情况下,选择手术治疗,效果理想。
Objective To investigate the diagnosis and treatment of longitudinal epileptic seizures in the central area. Methods The clinical data of 6 patients with epilepsy were retrospectively analyzed. All patients were evaluated preoperatively, including clinical manifestations, MRI, VEEG, cryptographic electrodes, buried electrodes and / or ECoG, Magnetoencephalography (MEG) examination, diagnosed as central longitudinal epilepsy. Through cortical electrical stimulation, stereotactic guidance, awakening and other methods to clear the scope of lesions and functional areas and the mutual relationship between the location, in the cortical EEG monitoring downlink microsurgical resection induced foci. Results Lesion resection in 3 cases, most resection in 3 cases. No postoperative bleeding, complications such as infection appear, no accident occurred. Postoperative pathological results were: 1 case of glial proliferation, focal cortical dysplasia Ⅱ a1 cases, Ⅱ b2 cases, lipoma in 1 case, cavernous hemangioma in 1 case. Six patients were followed up for 13 to 23 months, according to Engel classification: grade Ⅰ in 5 cases and grade Ⅱ in 1 case. Conclusion In the central region, the manifestations of longitudinal division of epilepsy are distinct. After the diagnosis, the surgical treatment is performed with accurate positioning of the foci and the functional area. The results are satisfactory.