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皮质脑电图监测下手术治疗颅内异物残留所致顽固性癫痫:病例报告及文献复习

Surgical cure of intractable epilepsy caused by retained intracranial foreign body under cortical electroencephalography monitoring: case report and literature review.

作者信息

Tan Zhigang, Wang Ming, Wan Jingwei, Li Xinxin, Cui Yan

机构信息

Department of Neurosurgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.

出版信息

Front Surg. 2025 Jun 6;12:1614564. doi: 10.3389/fsurg.2025.1614564. eCollection 2025.

Abstract

Post-Traumatic Epilepsy is a common and severe complication following brain trauma. However, there are few reports on intractable epilepsy caused by retained foreign bodies. This article reports a case of a patient with a metal foreign body retained in the cranium for 20 years due to trauma, resulting in drug-resistant epilepsy which type is focal to bilateral tonic-clonic seizure. Through preoperative imaging and neurophysiological techniques, the foreign body and epileptogenic zone were precisely located. Intraoperative cortical electroencephalography monitoring was used to accurately remove the foreign body and resect the epileptogenic focus, which pathological result indicates gliosis and calcification. The intractable epilepsy was effectively controlled, and the patient experienced no seizures postoperatively.

摘要

创伤后癫痫是脑外伤后常见且严重的并发症。然而,关于异物残留导致难治性癫痫的报道较少。本文报道了1例因外伤导致金属异物残留颅内20年,引发耐药性癫痫(发作类型为局灶性继发全面强直阵挛发作)的患者。通过术前影像学和神经生理学技术精确定位异物及致痫区。术中采用皮质脑电图监测,精准取出异物并切除致痫灶,病理结果显示胶质增生和钙化。难治性癫痫得到有效控制,患者术后无癫痫发作。

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