Background：Over past two decades,vagus nerve stimulation （VNS） has been widely used and reported to alleviate seizure frequency worldwide,however,so far,only hundreds of patients with pharmaco-resistant epilepsy （...Background：Over past two decades,vagus nerve stimulation （VNS） has been widely used and reported to alleviate seizure frequency worldwide,however,so far,only hundreds of patients with pharmaco-resistant epilepsy （PRE） have been treated with VNS in China's Mainland.The study aimed to evaluate the effectiveness of VNS for Chinese patients with PRE and compare its relationship with age cohort and gender.Methods：We retrospectively assessed the clinical outcome of 94 patients with PRE,who were treated with VNS at Beijing Fengtai Hospital and Beij ing Tiantan Hospital between November 2008 and April 2014 from our database of 106 consecutive patients.The clinical data analysis was retrospectively examined.Results：Seizure frequency significantly decreased with VNS therapy after intermittent stimulation of the vagus nerve.At last follow-up,we found McHugh classifications of Class Ⅰ in 33 patients （35.1％）,Class Ⅱ in 27 patients （28.7％）,Class Ⅲ in 20 patients （21.3％）,Class Ⅳ in 3 patients （3.2％）,and Class Ⅴ in 11 patients （l 1.7％）.Notably,8 （8.5％） patients were seizure-free while ≥50％ seizure frequency reduction occurred in as many as 60 patients （63.8％）.Furthermore,with regard to the modified Engel classification,12 patients （12.8％） were classified as Class Ⅰ,l l patients （11.7％） were classified as Class Ⅱ,37 patients （39.4％） were classified as Class Ⅲ,34 patients （36.2％） were classified as Class Ⅳ.We also found that the factors of gender or age are not associated with clinical outcome.Conclusions：This comparative study confirmed that VNS is a safe,well-tolerated,and effective treatment for Chinese PRE patients.VNS reduced the seizure frequency regardless of age or gender of studied patients.展开更多
Long-term epilepsy associated tumors(LEAT) represent a well known cause of focal epilepsies. Glioneuronaltumors are the most frequent histological type consisting of a mixture of glial and neuronal elements and most c...Long-term epilepsy associated tumors(LEAT) represent a well known cause of focal epilepsies. Glioneuronaltumors are the most frequent histological type consisting of a mixture of glial and neuronal elements and most commonly ariseing in the temporal lobe. Cortical dysplasia or other neuronal migration abnormalities often coexist. Epilepsy associated with LEAT is generally poorly controlled by antiepileptic drugs while, on the other hand, it is high responsive to surgical treatment. However the best management strategy of tumor-related focal epilepsies remains controversial representing a contemporary issues in epilepsy surgery. Temporo-mesial LEAT have a widespread epileptic networkwith complex epileptogenic mechanisms. By using an epilepsy surgery oriented strategy LEAT may have an excellent seizure outcome therefore surgical treatment should be offered early, irrespective of pharmacoresistance, avoiding both the consequences of uncontrolled seizures as well as the side effects of prolonged pharmacological therapy and the rare risk of malignant transformation.展开更多
目的研究病灶性新皮质癫癎发作间期MEG和MRI一致性与预后的关系。方法 23例病灶性新皮质癫癎接受了术前评估及手术治疗,所有患者术前均接受MEG检测,数据分析处理采用等价电流偶极子(ECD)法和合成孔径法(SAMg2)。7例患者接受了颅内电极...目的研究病灶性新皮质癫癎发作间期MEG和MRI一致性与预后的关系。方法 23例病灶性新皮质癫癎接受了术前评估及手术治疗,所有患者术前均接受MEG检测,数据分析处理采用等价电流偶极子(ECD)法和合成孔径法(SAMg2)。7例患者接受了颅内电极植入后长程视频皮层脑电图监测。术后随访一年以上并运用Engel法评价预后。结果 MEG与MRI一致的病例手术有效率(Engel class I or Ⅱ)及术后无发作率(Engel class IA)均优于不一致者。结论病灶性新皮质癫癎,MEG结果与MRI结果一致时手术效果良好,对此类病例不需要再进行颅内电极植入行癫癎灶定位,颅内电极植入仅适用于MEG结果与MRI结果不一致的病例或需要功能区定位者。展开更多
目的对于单侧大脑半球弥漫性病变引起的难治性癫痫，可以用大脑半球切除术或切开术治疗。本文总结作者最近进行的3例大脑半球切开术，同时进行了相应的文献复习。方法3例难治性癫痫，男2例，女1例，年龄分别为7、11、和15岁。均为一侧...目的对于单侧大脑半球弥漫性病变引起的难治性癫痫，可以用大脑半球切除术或切开术治疗。本文总结作者最近进行的3例大脑半球切开术，同时进行了相应的文献复习。方法3例难治性癫痫，男2例，女1例，年龄分别为7、11、和15岁。均为一侧半球病变，其中实施大脑半球完全切开术2例，后象限切开术1例。手术的目的是完全孤立致痫区域。结果3例患者分别随访22、22、12个月，其中Engel IA2例，Engel II B1例。无长期神经功能障碍或死亡病例。结论应用神经纤维离断技术进行大脑半球切开，可获得与切除术相同的控制癫痫的良好效果。展开更多
文摘Background：Over past two decades,vagus nerve stimulation （VNS） has been widely used and reported to alleviate seizure frequency worldwide,however,so far,only hundreds of patients with pharmaco-resistant epilepsy （PRE） have been treated with VNS in China's Mainland.The study aimed to evaluate the effectiveness of VNS for Chinese patients with PRE and compare its relationship with age cohort and gender.Methods：We retrospectively assessed the clinical outcome of 94 patients with PRE,who were treated with VNS at Beijing Fengtai Hospital and Beij ing Tiantan Hospital between November 2008 and April 2014 from our database of 106 consecutive patients.The clinical data analysis was retrospectively examined.Results：Seizure frequency significantly decreased with VNS therapy after intermittent stimulation of the vagus nerve.At last follow-up,we found McHugh classifications of Class Ⅰ in 33 patients （35.1％）,Class Ⅱ in 27 patients （28.7％）,Class Ⅲ in 20 patients （21.3％）,Class Ⅳ in 3 patients （3.2％）,and Class Ⅴ in 11 patients （l 1.7％）.Notably,8 （8.5％） patients were seizure-free while ≥50％ seizure frequency reduction occurred in as many as 60 patients （63.8％）.Furthermore,with regard to the modified Engel classification,12 patients （12.8％） were classified as Class Ⅰ,l l patients （11.7％） were classified as Class Ⅱ,37 patients （39.4％） were classified as Class Ⅲ,34 patients （36.2％） were classified as Class Ⅳ.We also found that the factors of gender or age are not associated with clinical outcome.Conclusions：This comparative study confirmed that VNS is a safe,well-tolerated,and effective treatment for Chinese PRE patients.VNS reduced the seizure frequency regardless of age or gender of studied patients.
文摘Long-term epilepsy associated tumors(LEAT) represent a well known cause of focal epilepsies. Glioneuronaltumors are the most frequent histological type consisting of a mixture of glial and neuronal elements and most commonly ariseing in the temporal lobe. Cortical dysplasia or other neuronal migration abnormalities often coexist. Epilepsy associated with LEAT is generally poorly controlled by antiepileptic drugs while, on the other hand, it is high responsive to surgical treatment. However the best management strategy of tumor-related focal epilepsies remains controversial representing a contemporary issues in epilepsy surgery. Temporo-mesial LEAT have a widespread epileptic networkwith complex epileptogenic mechanisms. By using an epilepsy surgery oriented strategy LEAT may have an excellent seizure outcome therefore surgical treatment should be offered early, irrespective of pharmacoresistance, avoiding both the consequences of uncontrolled seizures as well as the side effects of prolonged pharmacological therapy and the rare risk of malignant transformation.
文摘目的研究病灶性新皮质癫癎发作间期MEG和MRI一致性与预后的关系。方法 23例病灶性新皮质癫癎接受了术前评估及手术治疗,所有患者术前均接受MEG检测,数据分析处理采用等价电流偶极子(ECD)法和合成孔径法(SAMg2)。7例患者接受了颅内电极植入后长程视频皮层脑电图监测。术后随访一年以上并运用Engel法评价预后。结果 MEG与MRI一致的病例手术有效率(Engel class I or Ⅱ)及术后无发作率(Engel class IA)均优于不一致者。结论病灶性新皮质癫癎,MEG结果与MRI结果一致时手术效果良好,对此类病例不需要再进行颅内电极植入行癫癎灶定位,颅内电极植入仅适用于MEG结果与MRI结果不一致的病例或需要功能区定位者。
文摘目的对于单侧大脑半球弥漫性病变引起的难治性癫痫，可以用大脑半球切除术或切开术治疗。本文总结作者最近进行的3例大脑半球切开术，同时进行了相应的文献复习。方法3例难治性癫痫，男2例，女1例，年龄分别为7、11、和15岁。均为一侧半球病变，其中实施大脑半球完全切开术2例，后象限切开术1例。手术的目的是完全孤立致痫区域。结果3例患者分别随访22、22、12个月，其中Engel IA2例，Engel II B1例。无长期神经功能障碍或死亡病例。结论应用神经纤维离断技术进行大脑半球切开，可获得与切除术相同的控制癫痫的良好效果。
