顶枕及颞顶枕离断手术治疗难治性癫癎

目的探讨顶枕及颞顶枕离断治疗难治性癫癎的疗效。方法回顾性分析16例难治性癫癎病人的临床资料,其中行颞顶枕离断9例,顶枕离断5例,颞叶切除及顶枕离断2例。结果随访16例,时间0.5~3.9年,平均1.6年。根据Engel分级,术后疗效:Ⅰ级13例,Ⅱ级1例,Ⅲ级2例。术后发生脑水肿2例,无严重神经功能损伤及死亡病例。结论顶枕及颞顶枕离断技术是致癎灶位于一侧顶枕及颞顶枕部位的安全、有效的治疗方法。

Parietooccipital and temporoparietooccipital disconnection in the treatment of patients with intractable epilepsy

Objective To investigate the surgical outcomes of parietooccipital and temporoparietooccipital disconnection in the treatment of intractable epilepsy. Methods Clinical data of 16 patients with intractable epilepsy were analyzed retrospectively, including 9 patients treated by temporoparietooccipital disconnection, 5 by parietooccipital disconnection and 2 by temporal lobectomy and parietooccipital disconnection. Results Sixteen patients were followed up for 0.5 to 3.9 years with a mean period of 1.6 years. The postoperative outcomes were grade Ⅰin 13 patients, grade Ⅱ in 1 patient and grade Ⅲ in 2 patients according to Engel classification. Cerebral edema occurred in 2 patients. No severe neurological dysfunctions and death. Conclusions Parietooccipital and temporoparietooccipital disconnections are safe and effective methods for patients with epileptogenic focus in parietooccipital and temporoparietooccipital regions at one side.