解放军医学杂志2013，Vol.38Issue(3)：214-216,3.
颅脑术后继发癫痫的外科治疗(附25例临床分析)
Surgical treatment of secondary epilepsy after craniocerebral operation: a report of 25 cases
苏崇德 1于龙 1徐学军 1王瑞峰 1鹿鹏 1刘冲 1艾卿 1赵静静 1吴向利1
作者信息
摘要
Abstract
Objective To explore the preoperative evaluation and operative indications for intractable secondary epilepsy after craniocerebral operation, and to summarize the experiences of second craniotomy for epileptogenic zone resection, so as to improve the treatment efficacy of epilepsy secondary to neurosurgery. Methods From Jan. 2005 to May 2012, a total of 25 patients with secondary epilepsy after craniocerebral operation were evaluated carefully by assessment of medical history and pre-operative video electroencephalography (VEEG) examination. Electroencephalography or implantation of subdural electrodes for localizing the epileptogenic zone was conducted in each patient during and after epileptic attack. The epileptogenic zone was confirmed by electroencephalography, MRI and CT scanning before the second operation. The operation was performed along the original incision for complete exposure of the brain scar zone. After localization of the position and range of spike waves with cortical electrodes, the brain scar and epileptogenic focus were removed microscopically. After resection, re-examination was conducted with the cortical electrodes till brain wave rhythm became normal. Results No death or severe complication was found in the 25 patients. During a follow-up period of 6 months to 7 years, 18 patients were seizure free (Engel's class I), 5 patients were Engel's class Ⅱ, and 2 patients were Engel's class Ⅲ. No post-operative attack was found in 18 cases (72%), and 9 of them had their drugs withdrawn. Conclusion The medication effect of secondary epilepsy after craniocerebral operation is far from perfect, and second craniotomy could attain satisfactory results.关键词
神经外科手术/癫痫/创伤后/手术后并发症Key words
neurosurgical procedures/ epilepsy, post-traumatic/ postoperative complications分类
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苏崇德,于龙,徐学军,王瑞峰,鹿鹏,刘冲,艾卿,赵静静,吴向利..颅脑术后继发癫痫的外科治疗(附25例临床分析)[J].解放军医学杂志,2013,38(3):214-216,3.
