Kokubo Y, Kayama T, Saito S, Kuroki A, Saino M, Nakajima M
Department of Neurosurgery, Yamagata University School of Medicine.
No Shinkei Geka. 1997 Oct;25(10):959-64.
We report a 9-year-old girl with tuberous sclerosis presenting intractable adversive seizure. She had been suffering from frequent attacks of consciousness loss since the age of 6 years. Although a considerable amount of antiepileptic drugs had been administered, her epileptic attacks were not controlled, but instead rather increased. She had been suffering from adversive seizure to the right for more than 2 years. CT scan failed to show any abnormal density area. MRI showed a small lesion in the left frontal subcortical area. The electroencephalogram showed relatively mild abnormal waves in the left hemisphere. We undertook surgical removal of the lesion with epileptogenic foci because her epilepsy has not been controlled and the lesion could be a glioma. Abnormal spike waves were detected around the lesion with electrocorticogram. "Gyrectomy" technique was employed and the spike waves totally disappeared. After the surgery, no neurological deterioration was presented. She has suffered no seizure attack since the surgery even though the amount of the antiepileptic drugs has been significantly decreased. Resection of the epileptogenic foci as well as the abnormal lesion using the technique of gyrectomy is useful for the control of the intractable epilepsy, and makes the quality of life of patients much higher.
我们报告一名9岁患有结节性硬化症的女孩，出现难治性旋转性癫痫发作。她自6岁起就频繁发作意识丧失。尽管已使用了大量抗癫痫药物，但她的癫痫发作并未得到控制，反而有所增加。她向右的旋转性癫痫发作已持续两年多。CT扫描未显示任何异常密度区域。MRI显示左侧额叶皮质下区域有一个小病变。脑电图显示左半球有相对轻度的异常波。由于她所患癫痫未得到控制且该病变可能是胶质瘤，我们对伴有致痫灶的病变进行了手术切除。皮质脑电图在病变周围检测到异常棘波。采用了“脑回切除术”技术，棘波完全消失。术后未出现神经功能恶化。即使抗癫痫药物的用量已大幅减少，她术后也未再发作癫痫。采用脑回切除术技术切除致痫灶以及异常病变，对于控制难治性癫痫是有效的，并且能显著提高患者的生活质量。
