摘要目的 总结结节性硬化症所致癫痫患者的术前评估及手术方式,观察术后疗效.方法 回顾性分析北京三博脑科医院2004年6月至2011年6月手术治疗的20例结节性硬化症患者临床资料并系统随访1～5年.结果 经过综合评估,单纯致痫结节切除术8例；电极植入后致痫结节切除术1例；脑叶切除术4例；致痫结节切除+致痫皮层热灼术2例；脑叶切除+离断术1例；迷走神经刺激术2例；胼胝体全段切开术2例.术后随访Engel Ⅰ级11例,Ⅱ级2例,Ⅲ级5例,Ⅳ级2例,有效率达90％ (18/20).结论 经过精确术前评估,选择合适的手术方式,可以有效地控制或减轻结节性硬化引起的癫痫发作.

abstractsObjective To summary preoperative assessment and surgical approaches of tuberous sclerosis complex (TSC) patients.Methods We retrospectively analyzed the clinical data of 20 cases with epilepsy induced by TSC from June 2004 to June 2011 in Beijing Sanbo Brain Hospital.All the patients were fellowed up 1-5 years.Results Different surgical approaches had been made based on the pre-operative assessment.The pure nodules resection were made of 8 patients.The nodules resection were made after subdural electrodes implantation of 1 patient.The lobotomy was made of 4 patients.The nodule resection combined bipolar electro-coagulation on functional cortex (BCFC) were made of 2 patients.The lobotomy combined disarticulation was made of 1 patient.VNS was made of 2 patients.Corpus callosotomy was made of 2 patients.All the patients were fellowed up 1-5 years,averaged 2.9 years.Engel Ⅰ,in 11 patients ;Engel Ⅱ,in 2 patients; Engel Ⅲ,in 5 patients; Engel Ⅳ,in 2 patients.The effective rate was 90％(18/20).Conclusions By the accurate assessments,the epilepsy seizure which is induced by TSC can been controlled or reduced with different surgical approaches.