Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing 100093, China.
Epilepsy Res. 2012 Mar;99(1-2):139-46. doi: 10.1016/j.eplepsyres.2011.11.001. Epub 2011 Dec 10.
Although resection of an epileptogenic region remains the main procedure of epilepsy surgery, epileptogenic areas in functionally critical cortex cannot be approached in that manner. Bipolar electro-coagulation on functional cortex (BCFC) was developed to treat such refractory seizures without causing unacceptable neurological deficits. Here we report the outcome of this therapy.
Fifteen patients who underwent pure BCFC without resection between 2002 and 2008 were retrospectively reviewed with regard to seizure outcome, postoperative complications, and predictive factors.
Seven patients developed hemiparesis after the operation but fully recovered within 1-6 months. One patient developed mild dysphasia, which was resolved within 12 months. All neurological deficits were temporary in the sense that they ultimately did not result in a deficit that would be noticed during a standard clinical examination. There were no subdural hemorrhage and infection. Engel class I outcome was achieved in two (13.3%) patients; class II, in six (40%); class III, in three (20%); and class IV, in four (26.7%).
The BCFC technique is only a palliative surgery, and cannot be applied for all epilepsies, however, this therapy proved to be effective when the epileptogenic foci are located in unresectable cortex. BCFC is safe and easy to use.
尽管切除致痫区仍然是癫痫手术的主要方法，但在功能关键皮质中无法采用这种方法接近致痫区。双极电凝（BCFC）用于治疗这种无法治疗的癫痫发作，而不会引起不可接受的神经功能缺损。本文报告了这种治疗方法的结果。
回顾性分析了 2002 年至 2008 年间接受单纯 BCFC 治疗而未行切除术的 15 例患者的手术结果、术后并发症和预测因素。
术后 7 例患者出现偏瘫，但在 1-6 个月内完全恢复。1 例患者出现轻度构音障碍，12 个月内缓解。所有神经功能缺损均为暂时性，最终不会导致标准临床检查中注意到的缺陷。无硬膜下血肿和感染。2 例（13.3%）患者术后达到 Engel 分级 I；6 例（40%）为 II 级；3 例（20%）为 III 级；4 例（26.7%）为 IV 级。
BCFC 技术仅是一种姑息性手术，不能应用于所有癫痫，但当致痫灶位于无法切除的皮质时，该治疗方法有效。BCFC 安全且易于使用。
