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1、顽固性癫痫136例术后的临床分析 摘要：目的：回顾性对136例行了外科手术治疗的顽固性癫痫患者进行随访结果分析。方法：本组男95例同，女41例，临床表现全身强直－阵挛性发作65例，复杂部分性发作39例，失神发作20例，单纯部分性发作12例。所有病人术前均行了神经电生理检查和影像学检查。136例病人中，58例行脑立体定向手术，34例行前颞叶切除术（包括大部分海马和杏仁核），21例行胼胝体切开术，16例行脑皮质致痫灶切除术，5例行肿瘤切除术，4例行脑血管畸形切除术。结果：所有病人术后均得到了门诊或电话/通信随访，随访期为二年以上。结果发现42
2、例（30.8%）病人术后癫痫发作完全消失，62例（45.6%）发作显着改善，21例（15.4%）改善较好，9例（6.6%）改善较差的病人生活质量均有一定程度的提高。结论：癫痫的外科治疗不但可以使其癫痫发作得到控制，还可以减少抗癫痫药物的毒副反应，提高病人的生活质量。 Studyonfollow-upresultof136casesofintractableepilepsypost-operativelyTANGYun-linLIUWei-qinZHOULian-yinDepartmentofNeurosurgery,GuangzhouAirforce
3、HospitalofP.L.AGuangZhou,510602,Guangdong,ChinaAbstract:Obyective:Tostudythefollow-upresultof136casesofintractableepilepsyafteroperationretrospectively.MaterialandMethod:Inthisgrouptherewere95malesand41females.Theclinicalmanifestationreviewshowedtonic-clonicseizurein65cases,comp
4、lexpartialseizurein39,absenceseizurein20andsimpleparialseizurein12.BeforetheoperationallthepatientsreceivedroutinescalpEEGexamination,andCT/MRIscanning,Inthesepatients,Stereotacticsurgerywasperformedin58cases,anteriortemporallobectomy(Includingmostpartofhipplcampusandamygdalae)i
5、n34cases,corpuscallosotomyin21patients,corticalresectionin16,tumorresectionin5,andAVMresectionin4.Result:Allthepatientswerefollowedupthroughout-patientclinicandtelephone/letter,andthetimeoffollow-upwasmorethan2year.Satisfactoryoutcomewasachievedin42patients(30.8%),excellencein62
6、cases(45.6%),goodeffectin21(15.4%),badeffectin9(6.6%),noeffectin2(1.5%).Theoverallgoodeffectratewas91.1%,andbadaffectrate8.1%.Postoperativelyqualityoflife(QOL)improvedinmorethan90%ofthepatients,Conclusion:Epilepsysurgerycanmotonlycontrolseizure,butalsodecreasetheside-effectofAED
7、s,andimproveQOLofintractableepilepsypatients.locatedintheTomb,DongShenJiabang,deferthenextdayfocusedontheassassination.Linping,Zhejiang,1ofwhichliquorwinemasters(WuzhensaidinformationisCarpenter),whogotAfewbayonets,duetomissedfatal,whennightcameKeyWord:EpilepsySurgeryFollow-up
8、 0. 前 言自2002年1月至12月，我院对136例顽固性癫痫病人进行了外科手术治疗，通过
