癫痫致痫灶的定位

致痫灶的定位是选择外科手术方式的基础,也是决定手术效果的关键。我们对20例顽固性癫痫,术前根据病史,头皮脑电图(包括各种诱发试验)脑电地形图、颅内电极记录、CT,神经心理检查等进行综合评价,确定致痫灶。全组病例均手术治疗,随访6～18个月,发作完全消失16例,发作减少50%以上4例,无死亡。切除的致痫灶组织均行神经病理学检查,都发现有明显病理改变。

The Clinical Study of Localization of Epileptogenic Foci and Surgical Treatment

From July of 1989 to January of 1991,we performed surgical operations on 20 cases with intractable epilepsy.The preoperative localization of epileptogenic foci was based on a comprehensive evaluation of patients'seizure history,scalp EEG,topographic EEG display, cranial electrode recording,CT and neuropsychological investigations.Then,we selected an adequate surgical treatment,including 1 case of hemispherectomy,10 cases of anterior tem- poral lobectomy and 8 cases of extratemporal resection of the epileptogenic focus.Detected by electrocorticography and electrical stimulation monitoring,16 postoperative cases(80%) had seizure free and 4 cases(20%)had a more than 50% reduction in seizure frequency. The localization of epileptogenic foci,and surgical method and effect were discussed in detail. The key of surgical selection is to exactly localize epileptogenic foci with a comprehensive evaluation of various recordings and studies.The intracranial electrode recording is important for the localization of an epileptogenic focus.