摘要
目的探讨顽固性癫痫相关局灶性脑皮质发育不良(focal cortical dysplasia,FCD)的临床特点及手术效果。方法回顾分析经手术证实的21例顽固性癫痫相关FCD,总结其临床特点、术前筛查过程、手术、病理以及治疗结果等。FCD的定义和分型参照Palmini和Luders等癫痫病学家和神经病理学家在2004年确立的标准。手术后发作评价参考2001年国际抗癫痫联盟推荐的标准。结果 MRI发现异常12例,CT有1例轻微钙化。发生部位颞叶10例,额叶4例,顶枕叶7例。其中双重病理7例,均位于颞叶,6例联合颞叶内侧海马的硬化,1例患者同时合并海马硬化和额叶胶质疤痕。ⅠA有2例,ⅠB有11例,ⅡA有5例,ⅡB有3例。所有病例随访12-27个月。术后1级10例;2级7例;3级+4级3例;5级1例;无6级病例。并发症包括1例硬膜外血肿再次手术,2例颅内感染,2例皮下积液,无永久严重并发症。结论 以FCD为病理基础的顽固性癫痫,影像学检查多可发现异常,病理以ⅠB型最多见,可见于所有脑叶,手术切除效果好且安全。
Objective To study the effects of surgery on intractable epilepsy associated with focal cortical dysplasia （FCD）. Methods Twenty-one cases of surgery confirmed intractable epilepsy associated with FCD from 2009.1 to 2010.4 were analyzed retrospectively. The details summarized here included clinical characteristics, pre-surgical examinations, operations, pathological and treatment results. FCD was defined according to the criteria established in 2004 and surgical evaluation was conducted according to the recommendation by ILE in 2001. Results Twelve cases had abnormalities on MR[ and one case had mild calcification on CT scan. Lesions were located in the temporal lobe in 10 cases, the pari- etal-occipital lobe in 7 cases and the frontal lobe in 4 cases. Seven cases were found dual pathologies, of which,6 cases had combination with the hippocampus sclerosis in the temporal lobe and one case had combination of the hippocampus sclerosis and frontal glial scar. There were 2 cases of I A, 13 I B,5 H A, 1 1] B. All the patients were followed up for 12- 27 months. Post-surgical evaluation revealed grade I （47.6%） in 10 cases, 7 grade II （33.3%） in 7 cases, 3 grade III＋IV （14.3%） in 3 cases, and grade V （4.8%） in 1 cases. Complications included 1 case of epidural hematoma and surgery fol- lowed, 5 intracranial infection, and 2 subcutaneous hydrops. All patients did not have permanent severe complications.
出处
《中国神经精神疾病杂志》
CAS
CSCD
北大核心
2013年第5期269-273,共5页
Chinese Journal of Nervous and Mental Diseases
关键词
局灶性脑皮质发育不良顽固性癫痫手术
外科治疗
（1） Majority of patients with intractable epilepsy associated with FCD has abnormal signs on neuroimaging,（2） ｜ B is the most common pathological subtype of FCD. （3）, The surgery of FCD-induced intractable epilepsy is very el-
