Effect of surgical intervention on refractory posttraumatic epilepsy: a clinical analysis
10.3760/cma.j.issn.1671-8925.2009.06.018
- VernacularTitle:难治性外伤性癫痫的手术治疗分析
- Author:
Guan-Qian YUAN
1
;
Hong-Li XUE
;
Bo-Chuan LU
;
Xue-Ying SHI
;
Le-Ping LU
;
Hai-Feng ZHANG
Author Information
1. 沈阳军区总医院
- Keywords:
Posttraumatic epilepsy;
Epilepogenic loci;
Surgical treatment
- From:
Chinese Journal of Neuromedicine
2009;8(6):605-607
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical characteristics ofposttraumatic epilepsy, the correlation between epileptogenic foci and encephalomalacia, and the therapeutic effects of surgical intervention. Methods A retrospective analysis was performed among 13 patients with refractory post-traumatic epilepsy who received surgical intervention between February, 2003 and April, 2006. Results The first seizure attack occurred 0.5-13 years (mean 5.3 years) after craniocerebral injury in these patients. The epileptogenic loci were located around the encephalomalacia (ranging from 2 to 7 cm) in 8 patients, in the temporal lobe in 5 patients, in the medial temporal lobe in 4 patients (3 of whom sustained the injuries at 1.5-5 years of age with hippocampal glial proliferation shown by postoperative pathological examination), and in the neocortex of the temporal lobe in 1 case. All the patients underwent the operations under close monitoring of the cortical electroencephalogram, and 4 also received cranioplasty. The total effective rate of the surgery was 92.3% with an excellent outcome rate of 84.6% in the follow-up for 2-5 years. Conclusion The epileptogenic loci of posttraumatic epilpsy are usually adjacent to the encephalomalacia, and hippocampal sclerosis can be likely in patients with severe cerebral injury below 5 years of age. gefractory posttraumatic epilepsy often has favorable surgical outcome, and prompt surgery is suggested after the diagnosis.
