外科治疗颞叶继发性癫痫的临床分析

Surgical Teatment of Secondary Temporal Lobe Epilepsy

目的 探讨颞叶继发性癫痫的原因并总结手术治疗经验。方法对我院自1994年1月至2002年12月手术治疗的26例颞叶继发性癫痫患者的临床资料进行回顾性分析。手术方式是在皮层脑电图(ECoG)监测下采用病灶切除、病灶周致痫皮质切除、前颞叶切除和病灶周围皮质区多处软膜下横纤维切断等多种方法的组合。结果 26例病人无手术死亡及并发症。23例病人随访3个月～7年,症状完全消失者16例(占69.6％),术后癫痫发作显著减少者(发作频率不到原来的25％)5例(21.7％),术后癫痫发作减少者(发作频率不到原来的50％)2例(8.7％)。结论 多种手术方法结合治疗颞叶继发性型癫痫患者安全有效。

Objectives To explore the cause of secondary temporal lobe epilepsies and to sum up the experiences in surgically treating it. Methods The retrospective analysis of the clinical data was made in 26 patients with secondary temporal lobe epilepsy, who were operated on from January 1994 to December 2002. The resection of the foci and epileptogenic cortex surrouding them, anterior temporal lobectomy, and multiple subpial transection were performed under the intraoperative surveillance of ECoG. Results There were not surgical complications and no patients died. The data of following up from 3 months to 7 years in 23 patients showed that complete control of the seizure was obtained in 16 (69.6%) patients, significant reduction of the seizure in 5 (21.7%), reduction in 2 (8.7%). Conclusions The combined operation is safe and its effect on the control and reduction of the seizure is good in the patients with secondary temproral lobe eplilepsy.