Surgical Therapeutic Strategies Of Intractable Epilepsy

Objective To analyze the clinical features of intractable epilepsy (IE),and discuss the approach how to improve surgical skills and reduce the operative mortality and raise surgery curative effect.Methods 24 patients with IE treated of microsurgery in last 5 years were analyzed retrospectively, and 4 others cases of IE of microsurgery were analyzed prospectively. 13 of them underwent combined operations. All of the operations were performed with the guidance of intraoperative electrocorticography. The evaluation of ADL and registrations of frequency of IE paroxysm and the kinds of administration drug before and 6 months after surgery were analyze .The data before surgery delegate the cure effect of drug therapy and the data after operation delegate the effect of surgery. The data were expressed by mean±standard deviation. All data were analyzed by the software of SPSS 10.0.The various means compared by t test and proportion compared by Chi-square testResults All the patients were followed-up for 6 months to 5 years after operation . The kinds of drug were reduced significantly . The frequency of IE paroxysm reduce significantly (P<0.01) and ADL reduced significantly (P<0.05).In 18 patients were free from seizure (Engel's class I ),the seizure frequency decreased significantly (Engel's class II and III) in 8 patients, and unchanged (Engel's class IV) in 2 patients. No death or disability occur in all patients.Conclusions Epilepsy surgery can not only control seizure, but also decrease the quantity and side-effect of anti-epilepsy drugs and improve quality of life of patients with IE. The outcome effectiveness need further confirmation of larger series and long-term follow-up.