癫痫手术是治疗耐药性癫痫的一种行之有效的治疗方法，在某些情况下可以使用清醒开颅手术来去除致癫痫病灶，同时保留重要的大脑功能。我们介绍巴基斯坦首例报告的病例，患者为一名 19 岁女性，她接受了清醒癫痫手术以治疗皮质发育不良。她从小就有全身强直阵挛性癫痫病史，由于癫痫发作频率增加而被转诊至我们诊所。脑电图和核磁共振成像确定了右侧顶颞区的癫痫病灶。患者接受了神经导航引导的清醒开颅手术，并切除了右顶颞区的致痫灶。该手术使用头皮块和右美托咪定进行清醒镇静，使患者在整个手术过程中保持清醒。术中标测和皮质电图用于复杂的多学科护理。切除后皮质造影显示沿切除边缘没有尖峰。患者出院时没有出现任何并发症，并且在手术一年后仍然没有任何症状。清醒癫痫手术是去除致痫灶同时保留重要认知功能的可行选择。但在巴基斯坦等中低收入国家却很少使用。该病例的成功结果强调了在资源有限的情况下需要提高癫痫手术的认识和可用性。可以实施具有成本效益的措施，例如使用小型硬膜下条进行术中定位。版权所有 © 2023 韩国脑肿瘤协会、韩国神经肿瘤学会和韩国儿科神经肿瘤学会。

Epilepsy surgery is a well-established treatment for drug-resistant epilepsy, with awake craniotomy being used in certain cases to remove epileptogenic foci while preserving crucial brain functions. We are presenting the first reported case from Pakistan of a 19-year-old woman who underwent awake epilepsy surgery to treat cortical dysplasia. She had a history of generalized tonic-clonic seizures since her childhood and was referred to our clinic due to an increase in seizure frequency. EEG and MRI identified the epileptogenic focus in the right parieto-temporal region. The patient underwent a neuro-navigation guided awake craniotomy and an excision of the epileptogenic focus in the right parieto-temporal region. The procedure was carried out using a scalp block and dexmedetomidine for conscious sedation, enabling the patient to remain awake throughout the surgery. Intraoperative mapping and electrocorticography were used for complex multidisciplinary care. Post-resection corticography showed no spikes along the resected margins. The patient was discharged without any complications and remained free of symptoms a year after the surgery. Awake epilepsy surgery is a viable option for removing epileptogenic foci while preserving vital cognitive functions. However, it is seldom used in low- and middle-income countries such as Pakistan. The successful outcome of this case underscores the need for greater awareness and availability of epilepsy surgery in resource-limited settings. Cost-effective measures, such as using small subdural strips for intraoperative localization, can be implemented.Copyright © 2023 The Korean Brain Tumor Society, The Korean Society for Neuro-Oncology, and The Korean Society for Pediatric Neuro-Oncology.