Objective To explore the surgical treatment of epilepsy in rolandic and immediate perirolan dic cortex.Methods 376 patients accepted surgical treatment in our hospital from January 2010 to January 2016,of whom 48 patients fulfilled eligibility criteria and were included in the study.Patients were divided into 2 groups for analysis:patients with resections in the rolandic cortex (A group,n =28),and patients with resections in immediate perirolandic cortex and simultaneous sensorimotor multiple subpial transections (B group,n =20).Postoperative seizure outcome and neurologic deficits were analyzed.Results According to classification of Engel,Engel Ⅰ was in 22 (45.8％),Engel Ⅱ in 7 (14.6％),Engel Ⅲ in 10 (20.8％) and Engel Ⅳ in 9(18.8％).Seizure outcome satisfaction rate (Engel Ⅰ +Engel Ⅱ) in the group A was significantly higher than the group B (P =0.036);temporary and transient neurological deficits in the two groups had no statistically significant (P =0.569,P =0.418).Conclusions It is possible to achieve complete dissection of epileptic foci in rolandic and immediate perirolandic cortex without damage.The good prognosis is not related to the degree of excision of epilepsy and has no definite correlation with neurological dysfunction.

Objective To explore the surgical efficacy of meningioma patients with epilepsy as the main symptoms. Methods A retrospective analysis of 124 meningioma patients with epilepsy as the main symptoms between January 2010 and January 2016,follow-up effect of epilepsy control. Results There were 94 cases of Simpson I orⅡgrade resection,27 cases of gradeⅢresection and 3 cases of grade Ⅳ resection. The surgical out-comes of patients were evaluated based on Engel′s classification. There were 98 cases(79.0%)of EngelⅠgrade, 11 cases(8.9%)of EngelⅡgrade,Engel Ⅲ and Ⅳ grade were 12 cases(9.7%)and 3 cases(2.4%). Among them,87 of 94 patients with Simpson I orⅡ grade resection epilepsy were well controlled,the satisfaction rate of epilepsy control was 92.6%. Conclusions Epilepsy as the main symptoms of meningioma patients need to clear about the seizure onset area preoperative,need to pay special attention to whether there is an independent epilepsy starting area of the distant site of the tumor. On the basis of the tumor resection as much as possible,at the same time dealing with the abnormal release of the cortex can effectively improve the efficacy of postoperative epilepsy control.

Objective:To study the effectiveness and safety of great occipital nerve decompression in great occipital neurogenic intractable migraine.Methods:Fifty-one patients with great occipital neurogenic intractable migraine admitted to our hospital from December 2018 to December 2019 were chosen in our study. All patients were confirmed to be of great occipital neurogenic intractable migraine by blocked test and all patients underwent minimally invasive decompression of great occipital nerve. Preoperative and postoperative questionnaires were used to compare the severity of pain and frequency of pain episodes, and the prognoses of these patients were evaluated at the last follow-up.Results:Fifty-one patients were followed up for (12.02±3.36) months after surgery; at last follow-up, 10 patients were cured, 31 patients had obvious effect, 6 patients got improvement, 2 patients had poor effect, and 2 patients had no effect, with total effective rate of 80.40% (41/51). There were significant differences between before surgery and after surgery in the pain visual analog scale scores (7.47±0.76 vs.1.75±1.91) and frequency of pain episodes ([9.00±1.74] times/month vs. [2.82±2.47] times/month, P<0.05). Seven patients had temporary numbness at the surgical site after surgery, but 6 patients improved about 3 months after surgery and only one patient had persistent numbness. Conclusion:Great occipital nerve decompression is an effective and safe treatment method for great occipital neurogenic intractable migraine.