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Resection of bilateral occipital lobe lesions during a single operation as a treatment for bilateral occipital lobe epilepsy

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World Journal of Clinical Cases 2021年第34期9卷 10518-10529页

作者： Yan-En Lyu Xiao-Fei Xu Shuang Dai Min Feng Shao-Ping Shen Guo-Zhen Zhang Hong-Yan Ju Yao Wang Xiao-Bo Dong Bin Xu Seventh Clinical School of Medicine Beijing University of Chinese MedicineTongchuan 727031Shaanxi ProvinceChina Neurosurgery and epilepsy Centre Dongzhimen HospitalBeijing University of Chinese MedicineBeijing 100700China Neurosurgery and epilepsy Centre General Hospital of Beijing Military Commanding RegainBeijing 100700China

BACKGROUND Neurosurgical treatment of severe bilateral occipital lobe epilepsy usually involves two operations several mos *** To evaluate surgical resection of bilateral occipital lobe lesions during a single operation as a treatment for bilateral occipital lobe *** This retrospective case series included patients with drug-refractory bilateral occipital lobe epilepsy treated surgically between March 2006 and November *** Preoperative evaluation included scalp video-electroencephalography(EEG),magnetic resonance imaging,and *** surgery(bilateral occipital craniotomy),epileptic foci and important functional areas were identified by EEG(intracranial cortical electrodes)and cortical functional mapping,*** were followed up for at least 5 years to evaluate treatment outcome(Engel grade)and visual *** 20 patients(12 males)were aged 4-30 years(median age,12 years).Time since onset was 3-20 years(median,8 years),and episode frequency was 4-270/mo(median,15/mo).Common manifestations were elementary visual hallucinations(65.0%),flashing lights(30.0%),blurred vision(20.0%)and visual field defects(20.0%).Most patients were free of disabling seizures(Engel grade I)postoperatively(18/20,90.0%)and at 1 year(18/20,90.0%),3 years(17/20,85.0%)and≥5 years(17/20,85.0%).No patients were classified Engel grade IV(no worthwhile improvement).After surgery,there was no change in visual function in 13/20(65.0%),development of a new visual field defect in 3/20(15.0%),and worsening of a preexisting defect in 4/20(20.0%).CONCLUSION Resection of bilateral occipital lobe lesions during a single operation may be applicable in bilateral occipital lobe epilepsy.

关键词： Drug-resistant epilepsy occipital lobe epilepsy Bilateral lesions One-stage surgery Treatment outcome Visual fields

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