临床神经外科杂志2019，Vol.16Issue(4)：304-308,314,6.DOI:10.3969/j.issn.1672-7770.2019.04.006
结节性硬化的诊断及相关药物难治性癫痫的手术治疗
Diagnosis of tuberous sclerosis and surgical treatment for related drug-refractory epilepsy
摘要
Abstract
To summarize the diagnosis of tuberous sclerosis and the surgical treatment of its related drug-refractory epilepsy.Methods The clinical data of 10 patients of tuberous sclerosis complicated with drug-refractory epilepsy underwent surgical treatment from April 2015 to July 2018 in Guangdong Sanjiu Brain Hospital were analyzed retrospectively and related literatures were reviewed.In this group of patients, two strategies were proposed for the treatment of epileptogenic foci: direct epithelial cortical electrode monitoring and SEEG monitoring. Results The lesions in patients with tuberous sclerosis involved multiple systems and could cause complex clinical manifestations.The involvement of the nervous system was mainly characterized by drug-refractory epilepsy and cognitive impairment.The types of seizures could be diverse.The EEG showd focal or multifocal spike-slow waves in one hemisphere , or multifocal spike-slow waves in multiple hemisphere or even comprehensive spike-slow waves.MRI showed multiple abnormal signals in the cortex, subcortex and subependymal membrane.Subependymal giant cell astrocytoma could be seen occasionally , while CT examination showed calcification.After 3 months to 3 years and a half of follow-up, all patients were all Engle I grade , except one patient Engle III grade.Conclusions It is not difficult to diagnosis with tuberous sclerosis , according to the clinical manifestations of patients and combining with genetic and imaging examinations.Choosing the right case for active surgical treatment can achieve good results for the tuberous sclerosis patients with drug -refractory epilepsy.关键词
结节性硬化/术中皮层电极监测/SEEG监测技术/显微外科手术治疗Key words
tuberous sclerosis/intraoperative cortical electrode monitoring/SEEG monitoring/microsurgery treatment分类
医药卫生引用本文复制引用
华刚,谭红平,姜楠,李少春,张立民,陈俊喜,郭强,朱丹..结节性硬化的诊断及相关药物难治性癫痫的手术治疗[J].临床神经外科杂志,2019,16(4):304-308,314,6.基金项目
广东省医学科研基金(B2018169) （B2018169）
