无海马硬化表现颞叶癫痫的临床特点及手术疗效研究

Analysis of the clinical features of non-hippocampal sclerosis temporal lobe epilepsy and effect of operation

目的研究无海马硬化表现颞叶癫痫(HS-TLE)临床特点以及改良前颞叶海马杏仁核切除术后疗效。方法经MRI检查16例符合HS-TLE诊断的患者分别经评价发作症状,视频脑电图检查,PET-CT检查。经过术后半年以上随访评价术后发作频率,发作症状表现以及术后用药。结果HS-TLE临床发作特点与典型海马硬化颞叶癫痫(HS+TLE)相似但其全身强直-阵挛性发作以及感觉运动性发作形式较为常见,脑电图异常以及PET低代谢范围更加广泛。改良式前颞叶海马杏仁核切除术后75%患者改善在50%以上,表现在发作减少,发作时症状减轻,术后用药减少。结论HS-TLE有其不同于HS+TLE自身的临床特点,改良式前颞叶海马杏仁核切除术对HS-TLE是有效的治疗方法,但仍需更多病例以及更长时间的随访研究。

Objective To study the clinical features of non-hippocampal sclerosis temporal lobe epilepsy（non-HS TLE）and ameliorated hippocampus amygdala anterior temporal lobe resection effect.Methods After MRI examination,16 cases had the diagnosis of non-hippocampal sclerosis of temporal lobe epilepsy were assessed by monitoring the performance of seizure,video EEG and PET-CT examination,while refinement of the observed object.After follow-up more than six months evaluated seizure frequency,onset of symptoms and post-operative medication.Results The clinical features of is similar to type of hippocampal sclerosis temporal lobe epilepsy（HS TLE） but its generalized tonic-clonic seizures and the form of sensory-motor seizures are more common,abnormal EEG,and PET with low metabolic scope more extensive.After ameliorated hippocampus amygdala anterior temporal lobe resection,75% of patients improved more than 50% Manifested in Seizure reduction,Symptom alleviation and reduction of postoperative medication.Conclusion Non-HS TLE has its own clinical features different from the type of HS TLE.Ameliorated hippocampus amygdala anterior temporal lobe resection is effective treatment,but still need more cases and longer follow-up study.