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采用伽玛刀放射手术行胼胝体切开术治疗一例难治性全面性癫痫。

Corpus callosotomy with gamma knife radiosurgery for a case of intractable generalised epilepsy.

机构信息

Department of Radiology, Tehran University of Medical Sciences, Iran.

出版信息

Epileptic Disord. 2011 Jun;13(2):202-8. doi: 10.1684/epd.2011.0436.

Abstract

Gamma knife radiosurgery is a minimally invasive procedure which can be used for patients with intractable epilepsies as an alternative for surgical corpus callosotomy. We report a 13-year-old boy with intractable epilepsy who underwent radiosurgical callosotomy. The patient demonstrated significant clinical improvement after gamma knife radiosurgery and was free of seizures 10 months after the procedure. However, He developed four short focal seizures with clonic movements during the 20 months post radiosurgery. Corpus callosotomy decreased epileptiform discharges in both hemispheres, indicating a role for the callosal neurons to facilitate an asymmetric epileptogenic susceptible state within the two hemispheres such that bisynchronous and bisymmetrical epileptiform discharges develop. Our result demonstrates that this novel therapeutic approach is a safe and effective option for the treatment of intractable generalised epilepsies.

摘要

伽玛刀放射外科手术是一种微创治疗方法,可用于无法进行手术胼胝体切开术的难治性癫痫患者。我们报告了一例 13 岁难治性癫痫患者接受了放射外科胼胝体切开术。患者在伽玛刀放射外科手术后表现出明显的临床改善,并且在手术后 10 个月没有癫痫发作。然而,他在放射外科手术后 20 个月内出现了 4 次伴有阵挛运动的短暂局灶性癫痫发作。胼胝体切开术减少了两个半球的癫痫样放电,表明胼胝体神经元在两个半球之间促进了一种不对称的致痫易感状态,从而导致双同步和双对称的癫痫样放电。我们的结果表明,这种新的治疗方法是治疗难治性全面性癫痫的一种安全有效的选择。

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