
难治性癫痫的外科治疗进展
陈天懿, 赖伊杰, 张小小, 刘伟, 曹春燕, 孙伯民, 占世坤
难治性癫痫的外科治疗进展
Advances in surgical treatment of refractory epilepsy
在癫痫患者中,药物难治性癫痫一直占据相当比例。这部分患者在经过精确的评估后或可通过外科治疗的手段达到发作缓解。本文阐述了难治性癫痫的术前神经电生理和影像评估方法,并结合最新临床研究进展,针对不同类型癫痫总结手术治疗方案,补充阐述了无创治疗方法,且在此基础上探讨了癫痫外科治疗未来发展趋势。
Medically refractory epilepsy has always affected a considerable proportion of patients with epilepsy. This group of patients may be able to achieve seizure remission by means of surgical treatment after precise evaluation. This article presents preoperative neurophysiological and imaging evaluation methods for refractory epilepsy,and summarizes surgical options for different types of epilepsy in the light of new clinical research advances. We also have a discussion on non-invasive treatments as well as related future trend in surgical treatment for epilepsy.
refractory epilepsy / neurological diagnostic technique / neurosurgical procedure
R742.1
1 |
Anonymous. Epilepsy:a public health imperative[EB/OL] [2023-12-13].
|
2 |
孙纪涛,王 斌,李佳音,等. 长程视频脑电图在诊断癫痫中的应用价值研究[J]. 临床医药文献电子杂志,2018,5(99):139,142.
|
3 |
陈 洋. 长程视频脑电图在癫痫及其鉴别诊断中的临床应用分析[D]. 苏州:苏州大学,2017.
|
4 |
肖 岩,韦文科. 诱发试验在癫痫诊断及鉴别诊断中的价值[J]. 华夏医学,2007,20(3):621-623.
|
5 |
遇 涛. 正确认识脑磁图在癫痫外科中的应用价值[J]. 癫痫与神经电生理学杂志,2023,32(2):65-69.
|
6 |
田小霖,王 静,王雄飞,等. 癫痫术前评估中相关脑成像技术的应用及研究进展[J]. 癫痫与神经电生理学杂志,2023,32(2):113-116,125.
|
7 |
|
8 |
|
9 |
中国抗癫痫协会立体定向脑电图与脑定位学专业委员会,中国医师协会神经外科医师分会,国家神经外科机器人示范项目专家指导委员会. 立体定向脑电图临床应用的中国专家共识[J]. 中华医学杂志,2022,102(39):3095-3102.
Professional Committee of Stereotactic Electroencephalography and Brain Localization,Chinese Association Against Epilepsy,Chinese Congress of Neurological Surgeons,National Neurosurgical Robotics Demonstration Program Expert Steering Committee. Chinese expert consensus on the clinical application of stereotactic electroencephalography[J]. Natl Med J China,2022,102(39):3095–3102.
|
10 |
|
11 |
中国抗癫痫协会,中华医学会神经外科学分会神经生理学组,中华医学会神经病学分会癫痫与脑电图学组,等. 癫痫外科术前评估中国专家共识(2022版)[J]. 中华神经外科杂志,2022,38(10):973–979.
Chinese Association Against Epilepsy,Neurophysiology Group of the Neurosurgery Section of Chinese Medical Association,Epilepsy and Electroencephalography Group of the Neurology Section of Chinese Medical Association,et al. Chinese expert consensus on preoperative evaluation of epilepsy surgery(2022 edition)[J]. Chin J Neurosurg,2022,38(10):973–979.
|
12 |
|
13 |
张洋铭,魏怡名,唐振刚. 难治性癫痫的外科诊疗进展[J]. 神经损伤与功能重建,2023,18(6):346-348,372.
|
14 |
|
15 |
|
16 |
徐冰茹,李峥辉,姚 一,等. 药物难治性半球病变性癫痫手术治疗效果及手术方式比较的回顾性研究[J]. 国际神经病学神经外科学杂志,2017,44(2):145-150.
|
17 |
|
18 |
|
19 |
|
20 |
中国医师协会神经外科分会功能神经外科学组,中国抗癫痫 协会,国家神经外科手术机器人应用示范项目专家指导委员会. 立体定向脑电图引导射频热凝毁损治疗药物难治性癫痫的中国专家共识[J]. 中华医学杂志,2021,101(29):2276-2282.
Functional Neurosurgery Group of Chinese Congress of Neurological Surgeons,Chinese Association Against Epilepsy,National Neurosurgical Robotics Demonstration Program Expert Steering Committee. China expert consensus on stereotactic EEG-guided radiofrequency thermocoagulation in the treatment of drug-refractory epilepsy[J]. Natl Med J China,2021,101(29):2276-2282.
|
21 |
|
22 |
|
23 |
|
24 |
|
25 |
|
26 |
|
27 |
|
28 |
|
29 |
|
30 |
|
31 |
|
32 |
|
33 |
|
34 |
|
35 |
|
36 |
|
37 |
Bouwens van der Vlis TAM,
|
38 |
|
39 |
|
40 |
|
41 |
|
42 |
|
43 |
|
44 |
|
45 |
|
46 |
|
47 |
|
48 |
|
49 |
|
50 |
|
51 |
|
52 |
|
53 |
|
54 |
|
55 |
王俊华,孟凡刚,刘阿力. 伽玛刀治疗颞叶癫痫的研究进展[J]. 中华神经外科杂志,2013,29(1):103-106.
|
56 |
|
57 |
|
58 |
|
59 |
|
60 |
|
61 |
|
62 |
|
63 |
|
64 |
|
65 |
|
66 |
|
67 |
|
68 |
|
69 |
|
70 |
|
71 |
|
/
〈 |
|
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