189例颞叶癫痫手术疗效分析

Surgical treatment of temporal lobe epilepsy in 189 patients

目的评价难治性颞叶癫痫的手术疗效。方法对189例难治性颞叶癫痫的手术效果回顾性分析。结果随访1～14年,疗效按Engel的标准评定,189例中I级(术后即无癫痫发作)118例(62.4%),II级(极少发作,1～2次/年)29例(15.3%),III级(发作频率减少75%以上)26例(13.8%),IV级(无效)16例(8.5%)。总有效率为91.5%,效果优良率为77.7%。无严重并发症及手术死亡。结论外科手术治疗药物难治性颞叶癫痫是一种安全、有效的方法;对致痫灶的精确定位和彻底处理是提高疗效的关键。

Objective To evaluate the effect of operation on intractable temporal epilepsy. Methods The operation results in 189 patients with intractable temporal epilepsy were retrospectively analyzed. Results After one to fourteen years follow-up , one hundred and eighteen of 189 patients （62. 4%） had an Engel Class Ⅰ outcome after surgery and an additional twenty-nine patients （15, 3%） had rare seizure （Engel Class Ⅱ ）, and twenty-six patients had a decrease in seizure frequency （Engel Class Ⅲ）, no marked change（Engel Class Ⅳ） in sixteen patients （8. 5%）. Gross efficiency rate is 91.5%, No death and severe complication occurred in 189 patients. Conclusion Operation is a safe and efficient way to treat intractable temporal epilepsy, and it is critical step to resect epileptogenic lesion completely after locating it accurately.