“Central” commissurotomy for intractable generalized epilepsy
“Central” commissurotomy for intractable generalized epilepsy
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治疗顽固性全身性癫痫的“中央”连合术
DOI：
10.1212/wnl.32.7.687
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发表时间：
1982
期刊：
影响因子：
9.9
通讯作者：
M. Gazzaniga
中科院分区：
文献类型：
--
作者：
Donald H. Wilson;A. Reeves;M. Gazzaniga
第二组连续12例患者接受显微外科“中央”合并术（分割整个胼胝体和海马合并术）以缓解先前难治性全身性癫痫发作。这种改良手术被发现比在第一个系列的8例患者中进行的多次椎体切开术更安全，并且同样有效。中央合骨切开术被进一步改进为分两个阶段进行，这减少了“急性断连综合征”的时间和严重程度，这是术后早期常见的发病原因。在没有严重智障、有单侧脑损伤迹象、包括以全身性癫痫发作为主要形式的动力性发作的患者中，获得了最好的结果。脑电图显示，手术后双侧对称放电变为单侧或不对称放电，这强调了胼胝体在癫痫发作放电从一个半球到另一个半球的传导中所起的重要作用。
A second consecutive series of 12 patients underwent microsurgical “central” commissurotomy (division of the entire corpus callosum and hippocampal commissure) for the relief of previously intractable generalized seizures. This modified operation was found to be safer than the multiple commissurotomies performed in the first series of eight patients and was equally effective. Central commissurotomy was modified further by being performed in two stages, which reduced the length and severity of the “acute disconnection syndrome,” a common cause of morbidity in the early postoperative phase. Best results were obtained in patients who were not severely retarded, had signs of unilateral cerebral damage, and included akinetic spells as a prominent form of their generalized seizures. EEG showed that bilateral symmetric discharges became either unilateral or asymmetric after surgery, which emphasized the important role played by the corpus callosum in conducting seizure discharges from one hemisphere to the other.