Surgical Therapeutic Strategics Of Intractable Epilepsy

Objective To analysis the clinical features of intractabal epilepsy (IE),and discus how to improve surgical skill and reduce the operative mortality and improve surgery curative effect.Methods 24 cases of IE treated microsurgically in last 5 years were analyzed retrospectively, and 4 cases of IE were analyzed prospectively.13 of them underwent combined operations。 All operations were performed with the guidance of intraoperative electrocorticography.Evaluted ADL and register frequency of IE paroxysm and the kinds of dose before and 6 months after surgery.The datas before surgery delegated the cure result of druggery and the datas after surgery delegated the result of surgery.The datas expressed by mean±standard deviation.The datas analyzed by the software of SPSS 10.0.The mean of them compared by t test and proportion compared by Chi-squre test. Results All the patients were followed-up for 6 months to 5 years. The kinds of dose reduced evidently.The frequency of IE paroxysm reduced evidently(P＜0.01). ADL reduced evidently(P＜0.05).18 patients were seizure free (Engel′s class Ⅰ),the seizure frequency decreased significantly (Engel's class Ⅱand Ⅲ) in 8 patients, and unchanged (Engel's class Ⅳ) in 2 patients. No morbidity or mortality was observed in all patients. Conclusions Epilepsy surgery can not only control seizure, but also decrease the quanities and side-effect of anti-epilepsy drugs and improve quality of life of IE patients. These experiences need further confirmation of larger series and long-term follow-up.