DuanYu Ni, GuoJun Zhang, Liang Qiao, LiXin Cai, Tao Yu, YongJie Li
Department of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
Clin Neurol Neurosurg. 2010 Feb;112(2):110-7. doi: 10.1016/j.clineuro.2009.10.013. Epub 2009 Nov 13.
The objective of this study was to assess outcome with regard to seizure status and neurological function in patients undergoing resective surgery involving the perirolandic area.
All 15 patients who underwent perirolandic cortical resection between October 2006 and September 2007 at the Comprehensive Epilepsy Centre of Beijing Xuanwu Hospital were included in the study. The locations of functional cortical areas, ictal onset zones and epileptogenic lesions were mapped by chronic intracranial EEG recordings and electric cortical stimulation. Seizure outcome was determined using the modified classification of Engel and colleagues. Motor and sensory deficits were monitored.
At last follow-up 5 patients (33%) were in Engel class I, 4 (27%) were in class II, 3 (20%) were in class III, and 3 (20%) were in class IV. Nine patients suffered immediate functional deficits; 8 of these recovered completely within 2 weeks to 3 months of surgery. One had mild persistent loss of finger motor control.
After accurate presurgical evaluation using invasive recordings and functional brain mapping, epileptogenic cortical resection can give excellent results and few deficits in patients with perirolandic epilepsy.
本研究的目的是评估在涉及中央前回周围区域的切除性手术患者中癫痫发作状态和神经功能的结果。
纳入2006年10月至2007年9月在北京宣武医院综合癫痫中心接受中央前回周围皮质切除术的所有15例患者。通过慢性颅内脑电图记录和皮质电刺激来确定功能性皮质区域、发作起始区和致痫性病变的位置。使用Engel及其同事修改后的分类法来确定癫痫发作结果。监测运动和感觉功能障碍。
在最后一次随访时，5例患者（33%）处于Engel I级，4例（27%）处于II级，3例（20%）处于III级，3例（20%）处于IV级。9例患者出现即刻功能障碍；其中8例在术后2周内至3个月完全恢复。1例有轻度持续性手指运动控制丧失。
在使用侵入性记录和功能性脑图谱进行准确的术前评估后，致痫性皮质切除术可使中央前回周围癫痫患者获得良好的结果且功能障碍较少。
