ECoG定位颞前叶加选择性海马杏仁核切除治疗颞叶顽固性癫痫

目的探讨皮质脑电图(ECoG)定位颞前叶加选择性海马杏仁核切除手术对顽固性颞叶癫痫的治疗效果。方法对21例经脑电图、CT、MRI检查的顽固性癫痫患者,取大骨瓣开颅,术中ECoG定位,行颞前叶加选择性海马杏仁核切除术。结果本组21例无手术死亡和明显并发症。随访8个月～3年,疗效满意9例,显著改善8例,良好2例,差2例,发作频率减少50%以上者达90.5%,发作频率减少75%以上者为81.0%,术后均需继续服用抗癫痫药治疗。结论ECoG定位行颞前叶加选择性海马杏仁核切除术治疗顽固性颞叶癫痫,在减少海马切除范围的基础上能达到较好的疗效,是一种安全有效的手术。

Anterior Temporal Resection Appendant with Selective Amygdalohippocampectomy under the Location of ECoG for Refractory Temporal Lobe Epilepsy

Objective To investigate the efficacy of anterior temporal resection appendant with selective amygdalohippocampectomy under the location of ECoG for refractory temporal lobe epilepsy. Method 21 cases of refractory temporal lobe epilepsy confirmed by electroencephalogram, CT, and MRI preoperatively underwent the operations mentioned above. Result No morbidity and mortality occurred in this group.During 8 months to 3 years follow-up,the effect was satisfactory in 9 cases, obviously improved in 8 cases, false in 2 cases, false in 2 cases. 90.5% patients' seizure frequency decreased more than 50%, 81.0% patients' decreased more than 75%. But all the patients still needed the antiepileptic drug. Conclusion The procedure of anterior temporal resection appendant with selective amygdalohippocampectomy under the location of ECoG is recommended as a safe and effective method for refractory temporal lobe epilepsy, with superiority of clinical efficacy based on the less range of hippocampus resection.