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目的探讨伽玛刀治疗癫痫的可行性及有效性。方法 42例患者主要依据PET显像,结合癫痫发作特点、EEG、MRI等检查综合定位致痫灶,应用MASEP-SRRS型旋转式伽玛刀治疗,单纯性致痫灶照射边缘剂量为9～14 Gy,等中心曲线40%～60%。需加照射杏仁核和海马时,边缘剂量25～30Gy;照射胼胝体时中心剂量75～100 Gy,均为50等剂量曲线。随访15～70个月,观察发作频率、脑电图变化情况,评价治疗效果。结果随访15～70个月,有效率82%。结论 PET辅助定位下,低剂量伽玛刀治疗顽固性癫痫具有较高的有效率,无严重并发症,是一种有效的癫痫微侵袭外科治疗方法;采用9～14 Gy的周边剂量照射PET提示的致痫灶可取得良好效果。
Objective To investigate the feasibility and effectiveness of gamma knife in the treatment of epilepsy. Methods Forty-two patients were mainly treated with PET scintigraphy, combined with the characteristics of seizures, EEG, MRI and other tests to locate the epileptogenic focus. MASEP-SRRS rotary gamma knife was used to treat the patients. The marginal dose of simple epileptogenic irradiation was 9-14 Gy, isocenter curve of 40% to 60%. When irradiation with amygdala and hippocampus was required, the marginal dose was 25-30 Gy; when the corpus callosum was irradiated, the central dose was 75-100 Gy, which were equal dose curves. Follow-up 15 to 70 months, observe the frequency of seizures, EEG changes, evaluation of the treatment effect. Results follow-up 15 to 70 months, the effective rate of 82%. Conclusion PET-assisted localization of low-dose gamma knife treatment of intractable epilepsy with high efficiency, no serious complications, is an effective surgical treatment of epilepsy micro-invasion; the use of peripheral irradiation dose of 9 ~ 14 Gy PET prompt Of epileptogenic lesions can achieve good results.