论文部分内容阅读
目的探讨伽玛刀治疗运动功能区癫痫的最佳剂量、疗效及术前评估方法。方法 11例运动功能区癫痫患者通过5项主要评估指标〔临床症状、视频脑电图(VEEG)、MRI、脑磁图(MEG)、单光子发射计算机断层成像(SPECT/PET),考虑运动功能区癫痫者,加做运动功能区定位〕确定癫痫灶部位,行伽玛刀治疗。周边剂量11～14 Gy/50%,术前术后行心理状态及智力评估。结果按国际癫痫学会外科手术疗效分类法,有效率为10/11,患者在心理状态、智商等方面也得到明显改善;12 Gy组Ⅰ级例数最多,4例中3例达到Ⅰ级;14 Gy组并发症例数最多,3例中有2例出现并发症。结论伽玛刀治疗可较满意控制运动功能区癫痫发作,安全、损伤小;可以改善癫痫患者的心理状态及智力水平;治疗的关键在于严格把握术前评估,尤其是VEEG及放射剂量,低剂量伽玛刀治疗效果较好,12 Gy剂量治疗效果更好。
Objective To investigate the optimal dosage, efficacy and preoperative evaluation of Gamma Knife in the treatment of motor function epilepsy. Methods Eleven patients with motor function epilepsy were assessed by five major evaluation criteria (clinical symptoms, VEEG, MRI, MEG, SPECT / PET), motor function District epilepsy, plus motor function area positioning] to determine the location of epileptic foci, gamma knife treatment. Peripheral dose of 11 ~ 14 Gy / 50%, preoperative and postoperative mental state and intelligence assessment. Results According to International Society of Epilepsy Surgery Efficacy Taxonomy, the effective rate was 10/11. The patients’ mental status and IQ were also significantly improved. The number of grade Ⅰ in 12 Gy group was the highest, and in 3 of 4 cases it reached grade Ⅰ. Gy group had the highest number of complications and complications in 2 of 3 patients. Conclusion Gamma Knife treatment can be more satisfactory control of motor function area seizure, safety, less damage; can improve the psychological status and intelligence of patients with epilepsy; treatment is the key to strictly grasp the preoperative assessment, especially VEEG and radiation dose, low dose Gamma knife treatment is better, 12 Gy dose treatment effect is better.