Sandok E K, Cascino G D
Department of Neurology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.
Epilepsia. 1998;39 Suppl 4:S42-8. doi: 10.1111/j.1528-1157.1998.tb05124.x.
Our purpose was to evaluate the safety and efficacy of surgical treatment for perirolandic lesional epilepsy. We analyzed the records of 14 consecutive patients who underwent a stereotactic lesionectomy for intractable partial epilepsy between 1985 and 1994. All patients had a neuroimaging-identified lesion in the perirolandic cortex. The mean duration of follow-up was 6 years (range 1-11 years). Thirteen patients (93%) had a significant improvement in seizure tendency. Eleven patients (78%) were rendered seizure-free. Morbidity occurred in only one patient, who experienced an increased monoparesis after surgery. Stereotactic lesionectomy is an effective surgical strategy in patients with perirolandic lesional epilepsy. The recent development of functional brain imaging using subtraction ictal single-photon emission computed tomography co-registered with volumetric magnetic resonance imaging has been shown to be a reliable indicator of epileptic brain tissue that may significantly alter the preoperative evaluation in patients with extratemporal seizures.
我们的目的是评估手术治疗中央前回周围病灶性癫痫的安全性和有效性。我们分析了1985年至1994年间连续14例因顽固性部分性癫痫接受立体定向病灶切除术患者的记录。所有患者经神经影像学检查均发现中央前回周围皮质有病灶。平均随访时间为6年（范围1 - 11年）。13例患者（93%）的癫痫发作倾向有显著改善。11例患者（78%）实现无癫痫发作。仅1例患者出现并发症，术后单瘫加重。立体定向病灶切除术是治疗中央前回周围病灶性癫痫患者的一种有效手术策略。最近利用减影发作期单光子发射计算机断层扫描与容积磁共振成像联合的功能性脑成像技术已被证明是癫痫脑组织的可靠指标，这可能会显著改变颞叶外癫痫患者的术前评估。
