目的观察额叶致疒间灶切除术和选择性胼胝体切开术联合癫疒间灶周围多处软膜下横纤维切断手术治疗难治性额叶癫疒间的临床疗效。方法分析在我院接受多种术式联合治疗的19例难治性额叶癫疒间的临床资料,应用Engel标准进行术后效果分级,并对其中15例随访6个月~4a,总结手术体会,评价其远期疗效。结果按Engel分级:Ⅰ~Ⅱ级15例(78.9%),Ⅲ级4例(21.1%)。术后出现短暂肢体偏瘫6例,缄默2例,小便失禁3例,无死亡。癫疒间灶病理检查多为神经元变性及胶质增生。结论难治性额叶癫疒间手术治疗效果较满意,需要多种术式联合治疗才能提高手术效果。 Objective To observe the clinical effects of frontal lobe esophagectomy and selective corpus callosotomy combined with multiple subdural transverse transection around epileptic foci in the treatment of refractory frontal lobe epilepsy. Methods The clinical data of 19 patients with refractory frontal lobe epilepsy treated with various surgical procedures in our hospital were analyzed. The Engel criteria were used to evaluate the postoperative outcome. Fifteen of them were followed up for 6 months to 4a. Experience, evaluate its long-term efficacy. Results According to Engel classification, 15 cases (78.9%) were grade Ⅰ ~ Ⅱ and 4 cases (21.1%) were grade Ⅲ. Postoperative limb paralysis occurred in 6 cases, 2 cases of silent, urinary incontinence in 3 cases, no death. Epileptic lesions mostly neurodegeneration and glial hyperplasia. Conclusion The treatment of intractable frontal lobe epilepsy is more satisfactory, which requires a variety of surgical treatment in order to improve the surgical effect.