经侧裂选择性杏仁核海马切除术治疗颞叶内侧癫痫

Selective amygdalohippocampectomy via the transsylvian approach treats the mesial temporal epilepsy

目的探讨经侧裂选择性杏仁核海马切除术（TSSAH）治疗颞叶内侧癫痫（MTLE）的效果和手术并发症。方法对2005年至2008年采用TSSAH治疗的18例MTLE患者进行回顾性分析及随访。结果海马海绵状血管瘤4例（其中2例合并海马硬化），胶质瘤2例，海马硬化12例。术后随访6—37个月，Engel分级Ⅰ级（无发作）12例，Ⅱ级（仅先兆或偶发作）2例，Ⅲ级（发作显著减少）2例，Ⅳ级（发作无变化）2例。术后视野缺损9例，术区血肿1例，颅内感染1例，动眼神经损伤1例，无死亡、偏瘫及语言障碍。结论TSSAH治疗MTLE临床疗效满意。

Objective To study the effect of selective amygdalohippocampectomy via the transsylvian approach（TSSAH） for the mesial temporal lobe epilepsy （MTLE）. Method Retrospectively analyze seizure outcomes and operative complications of 18 patients with MTLE by TSSAH between Aug 2005 and Dec 2008. Results The pathologic changes were 4 cases cavernous haemangioma（2 of them with HS）, 2 cases glioma, 12 cases hippocampal sclerosis. The follow -up period was 6 to 37 months. After surgery, 12 patients were Engel class I （completely seizure free） ,2 patients were Engel class II ,2 patients were Engel class III, and 2 patients were Engel class IV. Visual field deficits existed in 9 patients, 1 patient had haematoma in operative zone, 1 patient had intracranial infection and 1 patient had oculomotor injury, no death and hemiplegia. Conclusions TSSAH can lead to favorable seizure control with a low irreversible complication risk.