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目的探讨儿童难治性癫痫的外科治疗方法。方法采用128导视频脑电图进行头皮及皮层电极描记,结合临床表现、颅脑CT、MRI等影象学检查精确定位,并根据不同部位采取不同的术式。结果手术4例,术后无中枢性感染、脑脊液漏等并发症出现,随访6月～10月,1例发作减少75%以上,余3例未再发作;智力均有不同程度的好转。结论多导联的皮层电极视频脑电监测是儿童难治性癫痫术前精确定位的较好的方法,而手术方法的正确选择是手术成败的关键。智力低下不应成为癫痫手术的禁忌症。
Objective To investigate the surgical treatment of intractable epilepsy in children. Methods The 128-lead electroencephalogram (EEG) was used for scrotal and cortical electrodeposition. According to the clinical manifestations, CT, MRI and other imaging were used to accurately locate the scalp and cortex. Different surgical procedures were taken according to different parts. Results There were 4 cases of surgery, no postoperative central infection, cerebrospinal fluid leakage and other complications. Follow-up ranged from June to October, the incidence of one episode decreased by 75% or more, and the remaining 3 cases had no recurrence. The intelligence had different degrees of improvement. Conclusion Multi-lead cortical electrodes video EEG monitoring is a good preoperative accurate positioning method for children with intractable epilepsy, and the correct choice of surgical methods is the key to the success or failure of the operation. Mental retardation should not be a contraindication to epilepsy surgery.