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find Keyword "皮层发育不良" 4 results
  • The application research of Magnetoencephalograph, Wada test combined with neuronavigation in the surgical treatment of frontal and temporal epilepsy caused by focal cortical dysplasia

    Objective To investigate the application of Magnetoencephalograph (MEG), Wada test combined with neuronavigation in the surgical treatment of frontal and temporal epilepsy caused by focal cortical dysplasia (FCD ). Methods The epileptogenic focus and IQ, memory and language examination were performed in 34 patients with frontal and temporal epilepsy caused by FCD. MEG and Wada test were conducted to determine the language and memory advantage hemisphere, and to clarify the scope and memory function of language function areas. Operation was guided by the Medtronic stealhealth 7 surgical navigation system (USA) to remove the FCD and protect nerve function. IQ, memory and language examination were measured 1 year after operation, and the difference was observed before and after operation. The postoperative follow-up was 23 ~ 46 months, curative effect of epilepsy was determined according to the international anti-epilepsy union Engel’s standard. Results Thirty-four patients with epilepsy (21 temporal lobe epilepsy and 13 frontal lobe epilepsy) were included in this study. The examination process of MEG and Wada test was smooth. MEG can accurately locate the position of language function area. Twenty-eight patients’ dominant hemisphere of language was on the left and 6 was on the right side. Wada test can evaluate the patient’s memory function. Twenty-three patients’ dominant hemisphere of memory was located on the left, 8 on the right and 3 on the bilateral hemisphere. Compared with the dominant hemisphere and nondominant hemisphere, the memory score was significantly different (P<0.05). Statistics showed that the verbal IQ and total IQ increased (P<0.05)1 year after operation, but there was no significant change in memory IQ and Performance IQ (P>0.05). FCD patients recovered well without language, memory and limb impairment. The curative effect of epilepsy: 15 cases of Engel’sⅠgrade, 14 cases of Engel’sⅡgrade and 5 cases of Engel’s Ⅲ grade. Conclusion MEG, Wada test combined with neuronavigation was of important value in locating and guiding the surgical resection of FCD in patients with refractory frontal and temporal epilepsy, protecting cortical function, avoiding severe postoperative complications, and improving the therapeutic effect of epilepsy.

    Release date:2018-01-20 10:51 Export PDF Favorites Scan
  • 局灶性皮层发育不良的临床病理分类新标准—ILAE 诊断方法委员会协作组专家共识

    局灶性皮层发育不良(Focal cortical dysplasia,FCD)是常与癫痫相关的大脑局灶性皮层构层异常疾病,儿童和成人均可患病。最近,ILAE 专项工作小组就 FCD 的分类新标准达成共识以更好地诠释其临床病理特征。32 名专家重新评价现存癫痫数据库中 FCD 患者的临床电生理表现、影像学数据、手术切除标本的神经病理表现及术后预后。专项工作小组就 FCD 分类提出 3 个亚型。FCDⅠ 型指皮层神经元构层异常的单发病灶,可以是串珠样小神经元垂直分布异常(FCDⅠa 型)或水平层次横贯性丢失(FCDⅠb 型),累及单一或多个脑叶。FCDⅡ型除特征性皮层神经元构层异常之外,还出现异形神经元(FCDⅡa 型)并发现气球样细胞(FCDⅡb 型)。相对于旧分类标准,新分类标准最大的变动是引入 FCDⅢ型:FCD 合并海马硬化(FCDⅢa 型),FCD 合并与癫痫相关的肿瘤(FCDⅢb 型),FCD 合并血管畸形(FCDⅢc 型),FCD 合并其他早期发生的外伤、卒中或脑炎所遗留的病灶(FCDⅢd 型)。新分类标准将为 FCD 患者临床、影像、电生理特征、术后癫痫控制及其分子病理机制研究提供重要依据。

    Release date:2021-01-07 02:57 Export PDF Favorites Scan
  • Pathological and clinical festures of 51 patients with focal cortical dysplasia

    ObjectiveTo explore the microscopic character and clinical pathological feature of focal cortical dysplasia (FCD).Methods51 cases were collected from January 2015 to September 2018 in the 988th Hospital of the Joint Logistics Support Force of the People’s Libereation Army. Pathology with FCD of their diseased brain tissue was classified according to the classification standard by the International Anti-Epilepsy Union (ILAE) in 2011. Epileptic seizure characteristics were analysed in different types.ResultsFCD I was 23 cases (45.1%). FCD II was 11 (21.6%). FCD III was 17 (33.3%). Ia was the most common type (23.5%, 12/51). Neurons were arranged into microcolumnar structures in Ia. NF expression in immunohistochemistry was characteristic. It was close to the neuron like line or waterfall. The second type was Ⅲa (15.7%, 8/51). Hippocampal sclerosis was given priority to CA4 area pyramidal cells to reduce or disappear. Three types all happened in bilateral cerebral hemisphere. There was no statistical difference. Temporal lobe was significantly more than frontal lobe. More than 50% of the cases occurredepilepsy before the age of 18. The main manifestation was partial onset seizures and secondary body stiffness clonus. The onset age and history of epilepsy in patients with FCD Ⅲ were earlier than those in the other two types. On image the positive rate of I type was 78.3% and that of Ⅱ and Ⅲ was both 100%.ConclusionFCD is a common pathological feature of epilepsy patients. Carefully pathologic examination is the premise of accurate classification of each subtype. Ⅲ type is different from Ⅰ and Ⅱ type in epileptic seizures.

    Release date:2021-10-25 01:58 Export PDF Favorites Scan
  • 1型神经纤维瘤病伴海马硬化及局灶性皮质发育不良癫痫手术治疗一例

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