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目的 探索顽固性癫痫患者初次手术后 ,癫痫发作不缓解或好转一段时间后再发作的原因。总结再手术的经验。方法 2 7例诊断明确的顽固性癫痫病人。初次经X 刀、γ 刀放射治疗的11例 ,立体定向下毁损的 2例 ,开颅手术的 14例。其中 2 5例癫痫发作曾经好转 ;2例癫痫发作如前。经再手术前综合评价后 ,在皮层脑电图监测下再手术治疗。治疗的重点是彻底处理致痫区。术后常规使用抗癫痫药物。结果 再手术后近期疗效较好 ,癫痫发作均明显减少 ,部分患者甚至能完全控制其癫痫发作。远期疗效有待继续观察。结论 顽固性癫痫的手术治疗在切除病灶的同时 ,对致痫灶要继续、彻底处理
Objective To explore the causes of recurrent seizures in patients with intractable epilepsy after their initial surgery without remission or improvement. Summarize the experience of re-operation. Methods Twenty-seven patients with well-defined refractory epilepsy. The first X-knife, gamma knife radiotherapy in 11 cases, stereotactic lesions in 2 cases, craniotomy in 14 cases. Twenty-five of the seizures had improved; two had seizures as before. After re-operation before a comprehensive evaluation, cesarean section in the corticosteroid monitoring and then surgery. The focus of treatment is the complete treatment of epileptogenic zone. Postoperative antiepileptic drugs routinely used. The results of the short-term effect after surgery is better, seizures were significantly reduced, some patients can even control their epileptic seizures. Long-term efficacy needs to be observed. Conclusion intractable epilepsy surgery in the removal of the lesion at the same time, to the epileptogenic focus to continue and thoroughly deal with