Objective To explore the strategy and outcome of surgery for the treatment of encephalomalacia with secondary intractable epilepsy.
Method sDuring the period of July 2009 and June 2015, 21 cases of encephalomalacia with secondary intractable epilepsy were performed operation. Among them there were 16 males and 5 females. Their ages ranged from 4 to 34 years, with their illness duration from 3 to 14 years. According to the results of MRI and video-EEG monitoring, all the patients were performed operation under the monitoring of ECoG. And the outcome was graded by Engle scales for analysis.
Result sECoG monitoring after the resection of encephalomalacia showed that there was still abnormal discharge. Enlarged cortical resection was performed in 10 cases, and cortical coagulation in 3、anterior temporal lobectomy + resection of the hippocampus and amygdala in 4、additional callosotomy in 4. The post-operative follow-up of 1~7 years showed that Grade Ⅰ was observed in 10 cases、Grade Ⅱ in 5 cases、Grade Ⅲ in 3 cases and Grade Ⅳ in 3 cases.The total surgical effectiveness was 85.7%.
Conclusion To the patients of encephalomalacia with secondary intractable epilepsy, the epileptic lesion should be resected besides the resection of encephalomalacia. And the surgical effectiveness is satisfactory.
Citation：
WANGHuanming, HUFei, SHAOQiang, CHENJun, XIAOKai, XIONGYubo, YANGYanping. Surgery for the treatment of encephalomalacia with secondary intractable epilepsy. Journal of Epilepsy, 2016, 2(5): 393-396. doi: 10.7507/2096-0247.20160069
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Copyright © the editorial department of Journal of Epilepsy of West China Medical Publisher. All rights reserved
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Lee YJ, Kim EH, Yum MS, et al. Long-term outcomes of hemispheric disconnection in pediatric patients with intractable epilepsy. J Clin Neurol, 2014, 10(2):101-107.
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Wyllie E, Lachhwani DK, Gupta A, et al. Successful surgery for epilepsy due to early brain lesions despite generalized EEG findings. Neurology, 2007, 69(4):389-397.
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赵明, 梁树立, 李安民, 等.局限性非外伤性脑软化灶相关癫痫的手术治疗.中华神经外科杂志, 2010, 26(6):500-502.
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刘琨, 王国栋, 张静华, 等. PET辅助定位脑软化灶伴发难治性癫痫的伽玛刀治疗中华神经医学杂志, 2007, 6(12):1260-1264.
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王超, 刘窗溪, 熊云彪, 等.皮层脑电图监测下多种术式联合治疗脑软化灶所致的继发性癫痫.山东医药, 2009, 49(26):19-20.
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Bennett-Back O, Ochi A, Widjaja E, et al. Magnetoencephalo-graphy helps delineate the extent of the epileptogenic zone for surgical planning in children with intractable epilepsy due to porencephaliccyst/encephalomalacia. J Neurosurg Pediatr, 2014, 14(3):271-278.
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- 1. Lawn N, Londono A, Sawrie S, et al.Occipitoparietal epilepsy, hippocampal atrophy, and congenital developmental abnormalities. Epilepsia, 2000, 41(6):1546-1553.
- 2. Lee YJ, Kim EH, Yum MS, et al. Long-term outcomes of hemispheric disconnection in pediatric patients with intractable epilepsy. J Clin Neurol, 2014, 10(2):101-107.
- 3. 孙吉林, 赵文清, 田中雨, 等.脑软化灶FLAIR高信号与癫痫灶关系初探.中国临床医学影像杂志, 2009, 20(10):733-735.
- 4. Wyllie E, Lachhwani DK, Gupta A, et al. Successful surgery for epilepsy due to early brain lesions despite generalized EEG findings. Neurology, 2007, 69(4):389-397.
- 5. 赵明, 梁树立, 李安民, 等.局限性非外伤性脑软化灶相关癫痫的手术治疗.中华神经外科杂志, 2010, 26(6):500-502.
- 6. 刘琨, 王国栋, 张静华, 等. PET辅助定位脑软化灶伴发难治性癫痫的伽玛刀治疗中华神经医学杂志, 2007, 6(12):1260-1264.
- 7. 王超, 刘窗溪, 熊云彪, 等.皮层脑电图监测下多种术式联合治疗脑软化灶所致的继发性癫痫.山东医药, 2009, 49(26):19-20.
- 8. Bennett-Back O, Ochi A, Widjaja E, et al. Magnetoencephalo-graphy helps delineate the extent of the epileptogenic zone for surgical planning in children with intractable epilepsy due to porencephaliccyst/encephalomalacia. J Neurosurg Pediatr, 2014, 14(3):271-278.
