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目的研究难治性癫痫的致痫灶精确定位和外科手术治疗的方法及疗效。方法对99例难治性癫痫患者应用影像学、视频脑电图、PET-CT等检查综合行癫痫灶定位和多种术式进行外科手术治疗。结果随访评估疗效满意者51例(51.5%),显著改善31例(31.2%),良好6例(6%),较差7例(7%),无改善4例(4%)。除1例额顶叶星形细胞瘤术后有偏瘫,1例再次手术出现偏瘫、失语者,1例行立体定向手术后出现偏瘫外,其余无明显及永久性神经系统并发症,无死亡病例。结论应用影像学、电生理、PET-CT等检查进行术前癫痫灶定位和多种术式进行外科治疗,可使难治性癫痫的治疗获得满意疗效。
Objective To study the precise location and surgical treatment of epileptic foci in patients with refractory epilepsy. Methods Ninety-nine patients with refractory epilepsy were treated with imaging, video-electroencephalography and PET-CT in combination with epileptic foci and various surgical procedures. Results Follow-up was evaluated in 51 patients (51.5%), 31 patients (31.2%), 6 patients (6%), 7 patients (7%) and 4 patients (4%). In addition to hemiplegia after anterior astrocytoma in one patient, hemiplegia and aphasia occurred in one case after reoperation, and hemiplegia after stereotactic operation in one case. There was no obvious or permanent neurological complications and no deaths . Conclusion The use of imaging, electrophysiology, PET-CT and other preoperative detection of epileptic focus and a variety of surgical treatment, can make the treatment of refractory epilepsy with satisfactory results.