摘要
目的探讨病理表现为皮质发育不良的难治性部分性癫的临床特征。方法回顾分析46例手术切除癫灶后,病理证实为皮质发育不良的难治性癫病例的影像学和脑电图表现以及手术疗效等资料,分析此类癫的临床特征。结果在46例中,癫灶的病理类型为轻度皮质发育不良10例、Ⅰ型局灶性皮质发育不良25例、Ⅱ型局灶性皮质发育不良5例、伴有胚胎发育障碍性神经上皮瘤和神经节胶质瘤的分别为4例和2例。通过磁共振成像(MRI)扫描可以发现局灶性皮质异常的12例(26·1%),海马硬化10例(21·7%),未见明显异常的24例(52·2%)。在发作间期,60·9%的病例为区域性的性放电,45·7%的病例表现出节律性样电活动。手术切除癫灶后,69·6%的病例发作消失。结论皮质发育不良约占MRI阴性表现的难治性癫病例的50%,以Ⅰ型局灶性皮质发育不良最为常见,发作间期脑电图常常显示节律性样电活动。
Objective To discuss the clinical, neuroimaging and electroencephalogram characteristics of patients with malformations of cortical development （MCD） undergoing surgical resection for intractable epilepsy. Methods A series of 46 patients with a histopathology of MCD were found out according to Palmini＇ s new criterion of MCD. Medical history, neuroimaging, non-invasive or invasive video-EEG recording and surgical outcome data were analyzed retrospectively. Results Twenty-three patients were conducted with temporal lobe resection, the other 23 with extra-temporal lobe resection. The 46 cases were divided into different pathologic subtypes according to the new classification of MCD： 10 Mild MCD, 25 FCD-1, 5 FCD-2, 4 dysembryoplastic neuroepithelial tumors （DNT） and 2 gangliogliomas. FCD-1 was the most common pathologic subtype in this series of patients with MCD. MRI showed focal cortical lesions in 12 patients （26. 1% ）,hippocampal sclerosis in 10 patients （21.7%）, and normal in 24 persons （52. 2% ）. Regional epileptiform discharge appeared in 60. 9% of the patients, and repetitive or rhythmic epileptiform in 45.7% of the patients in interictal EEG. 76. 1% of the patients undergone surgery achieved good outcome, and 69. 6% of whom were finally seizure free. Conclusions MCD accounts approximately for 50% of the patients with intractable epilepsy with normal MRI, and FCD-1 is the most common subtype of MCD. Repetitive or rhythmic epileptiform is often seen in interictal EEG of MCD patients.
出处
《中华神经科杂志》
CAS
CSCD
北大核心
2006年第3期148-151,共4页
Chinese Journal of Neurology
