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目的探讨立体定向技术对难治性多灶性癫痫的治疗效果。方法 2004年～2009年采用脑电图、MRI、脑磁图(magnetoencephalography,MEG)检查等术前综合评估,对双侧大脑半球均存在多个致痫区、无法进行开颅广泛致痫灶切除手术的难治性癫痫患者92例,采用立体定向技术进行胼胝体两侧、双侧杏仁核、内侧隔区及单侧Forel-H区等多靶点组合射频毁损治疗,手术后对患者进行跟踪随访、评定疗效。结果按照谭启富癫痫疗效分级,本手术对癫痫发作控制的满意率在术后1～5年达62%。结论对无法进行开颅行致痫灶切除手术的难治性多灶性癫痫患者,立体定向手术是一种较好的治疗手段。
Objective To investigate the therapeutic effect of stereotactic technique on refractory multifocal epilepsy. Methods From 2004 to 2009, preoperative comprehensive evaluation such as EEG, MRI and MEG was used to detect multiple epileptogenic zones in both hemispheres. Ninety-two patients with intractable epilepsy were treated by stereotactic radiofrequency ablation with multiple targets such as bilateral corpus callosum, bilateral amygdala, medial septal area and unilateral Forel-H area. The patients were followed up after surgery , Assess the efficacy. The results according to Tan Qifu epilepsy efficacy classification, the surgical satisfaction rate of epileptic seizures in the postoperative 1 to 5 years up to 62%. Conclusion Stereotactic surgery is a good treatment for patients with refractory multifocal epilepsy who can not undergo craniotomy for epileptogenic surgery.