[1]华刚,谭红平,张立民,等.枕叶癫痫的临床特点及手术治疗策略[J].临床神经外科杂志,2018,15(03):165-169.
 HUA Gang,TAN Hong-ping,ZHANG Li-min,et al.Clinical features and surgical treatment strategy of occipital lobe epilepsy[J].Journal of Clinical Neurosurgery,2018,15(03):165-169.
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枕叶癫痫的临床特点及手术治疗策略()
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《临床神经外科杂志》[ISSN:1672-7770/CN:32-1727/R]

卷:
15
期数:
2018年03期
页码:
165-169
栏目:
癫痫专题
出版日期:
2018-06-15

文章信息/Info

Title:
Clinical features and surgical treatment strategy of occipital lobe epilepsy
作者:
华刚谭红平张立民郭强朱丹
510510 广州,广东三九脑科医院癫痫中心癫痫外科
Author(s):
HUA GangTAN Hong-pingZHANG Li-minet al.
Department of Epilepsy Surgery,Guangdong Sanjiu Brain Hospital,Guangzhou 510510,China
关键词:
枕叶癫痫立体脑电图手术治疗策略
Keywords:
occipital lobe epilepsystereotactic electroencephalographysurgical treatment strategy
分类号:
R651
文献标志码:
A
摘要:
目的 探讨枕叶癫痫的临床特点和手术治疗策略。 方法 回顾性分析广东三九脑科医院癫痫中心癫痫外科2014年6月至2017年6月,经无创术前评估或有创立体脑电图(SEEG)监测证实手术治疗的14例枕叶癫痫患者的临床资料,并复习相关文献。 结果 4例低级别发育性肿瘤患者采取直接开颅术中皮层电极监测下行病灶切除,加痫样放电区切除;其中1例患者因未监测到痫样放电仅行病灶切除。10例患者均经SEEG监测明确致痫灶后,行手术治疗;其中行SEEG引导下射频热凝术2例,行开颅显微镜下致痫灶切除术8例。术后主要并发症为视野缺损或原有视野缺损加重。患者术后均常规服用抗痫药物;经6个月~3年的随访,其中Engle分级Ⅰ级12例、Engle分级Ⅲ级1例、Engle分级Ⅳ级1例。 结论 虽然枕叶癫痫的临床表现复杂,头皮脑电图检查定侧定位意义有限。但经详细规范的术前评估,特别是症状学演变分析,以及SEEG监测仍可以准确诊断;而采取个体化的手术治疗策略可以获得良好的效果。
Abstract:
Abstract:Objective To explore the clinical features and surgical treatment strategy of occipital lobe epilepsy.Methods The clinical data of 14 patients with occipital lobe epilepsy who were confirmed by noninvasive preoperative evaluation or invasive stereotactic electroencephalography(SEEG) technique from June 2014 to June 2017 in our department were analyzed retrospectively and relevant literatures were reviewed.Results Four patients with low-grade developmental tumors underwent direct craniotomy which included the lesion and the epileptiform discharge area.In one case,only the lesion was excised because no epileptiform discharge was detected in surgery.10 patients underwent SEEG technique to determine the epileptogenic zone before surgery.2 underwent SEEG-guided radiofrequency thermocoagulation and the others underwent craniotomy.The main complication after the operation was visual field defect or original visual field defect worse.After the operation,anti-epileptic drugs were routinely taken.The follow-up from 6 months to 3 years showed there were 12 cases of Engle class Ⅰ,1 Engle class Ⅲ and 1 Engle class Ⅳ.Conclusions Although the clinical manifestation of occipital lobe epilepsy is complex,scalp electroencephalography has limited significance in locating the side,it still can be accurately diagnosed through detailed normative preoperative evaluation,especially the evolution of symptoms and stereoscopic EEG monitoring techniques.Furthermore,it can obtain good result by taking individualized surgical treatment strategies.
更新日期/Last Update: 1900-01-01