病灶切除联合海马杏仁核切除治疗颞叶内侧占位病变所致癫痫

目的观察病灶切除联合海马杏仁核切除术治疗颞叶内侧占位病灶所致癫痫的手术效果。方法回顾分析颞叶内侧占位病灶所致癫痫且术中深部电极，探查出海马异常放电的16例患者，采用改良翼点切口开颅经颞中回皮层入路，行病灶切除联合海马杏仁核切除治疗，术后随访至少1年以上，采用Engel分级量表评价癫痫控制效果。结果16例患者均取得了占位病灶的肉眼全切，Engel分级：Ⅰ级12例，Ⅱ级3例，Ⅲ级1例，Ⅳ级0例；2例出现对侧1／4象限盲，3例出现近期记忆功能较术前下降，无手术死亡及其他持久并发症。结论病灶切除联合海马杏仁核切除术，治疗病侧海马异常放电的颞叶内侧占位病灶所致癫痫，并发症少，安全有效。

Study on treating epilepsy induce by tumor in mesial temporal lobe with mygdalohippocampectomy

Objective To observe the treating effects of epilepsy due to tumor in mesial temporal lobe with resection of space occupying lesion combined with and mygdalohippocampectomy. Method 16 patients with epilepsy due to mesial temporal lobe tumor and paradoxical discharge intraoperatively detected by depth electrode were retrosepectively reviewed , space occupying lesion resection combined with and amygdalo - hippocampectomy with modified pterional incision and transcortical of middle temporal gyms approach were performed . All the patients were followed for at least 1 year , Engel grade was used to evaluate the treating effects of epilepsy. Results The tumors in 16 patients were all resected . Surgical results were satisfactory（Engel Ⅰ in 12, Engel Ⅱ in 3, Engel Ⅲ in 1, Engel Ⅳ in 0）. 1/4 quadrantanopia involves opposite sides of the visual field was found in 2, recent memory reduction was found in 3. There was no long term computation or morbidity . Conclusion Space oocupying lesion resection confined amygdalo - hippocampeetomy is a safe ti, eatment for mesial temporal lobe epilepsy induced by paradoxical discharge is a safe treatment with less eomplicaitons .