基础医学与临床 ›› 2017, Vol. 37 ›› Issue (5): 723-725.

• 临床园地 • 上一篇    下一篇

半球离断术治疗半球性癫痫:疗效与并发症的早期随访

窦万臣1,郭毅2,郭金竹1,苏长保3,卢强1,金立日1,黄颜1,周祥琴1,吴立文1   

  1. 1. 北京协和医院
    2. 中国医学科学院 北京协和医学院 北京协和医院 神经外科
    3. 北京协和医院 北京
  • 收稿日期:2016-12-29 修回日期:2017-03-20 出版日期:2017-05-05 发布日期:2017-04-19
  • 通讯作者: 周祥琴 E-mail:zwypumc@126.com

Hemispherotomy for hemispheric epilepsy: outcome and early follow up for complications

  • Received:2016-12-29 Revised:2017-03-20 Online:2017-05-05 Published:2017-04-19
  • Contact: Xiang-Qin ZHOU E-mail:zwypumc@126.com

摘要: 目的 探讨半球离断术(hemispherotomy)治疗药物难治性半球性癫痫的早期效果和并发症。方法 自2011年至2013年,北京协和医院神经外科采用大脑半球离断术治疗药物难治性癫痫5例,均为一侧半球广泛弥漫性病变导致的药物难治性癫痫。经过仔细的术前评估检查后,均行大脑半球离断术治疗。结果 所有5例半球性癫痫患者手术顺利,围手术期过程平稳。术后对侧肢体运动和言语功能等和术前无明显变化。术后随访46~69个月,5例患者疗效均达到为Engel Ⅰ级。结论 半球离断术是半球切除术的重大改良,疗效与半球切除术相当。该方法早期并发症少。手术操作虽比较复杂但并非十分困难,值得推广应用。

关键词: 半球离断术, 半球切除术, 半球性癫痫, 外科治疗

Abstract: Objective To investigate the results and complications of hemispherotomy for drug resistant hemispheric epilepsy. Methods The authors reviewed 5 patients who were diagnosed as drug resistant hemispheric epilepsy and operated in the neurosurgery department of Peking Union Medical College Hospital from 2011 to 2013. All the 5 patients were underwent hemispherotomy after carefully multidisciplinary pre-operation evaluation. Results All patients tolerated the procedure well and the postoperative course was smooth. All the 5 patients were seizure free in the period of following up of 46 to 69 months. Conclusions According to literatures and the authors’ experience, hemispherotomy is as safe and efficient for hemispheric epilepsy as hemispherectomy. It is the most important modification for hemispherectomy. The procedure of hemispherotomy is complex but not very difficult, Illustrating a good prospect of application and extension.

Key words: hemispherotomy, hemispherectomy, hemispheric epilepsy, surgery