伽玛刀治疗颞叶内侧癫的长期随访研究

A long-term follow-up study of gamma knife for mesial temporal lobe epilepsy

目的探讨伽玛刀治疗颞叶内侧癫的长期疗效。方法回顾性分析应用伽玛刀治疗的46例顽固性颞叶内侧癫病人的临床资料。伽玛刀治疗范围包括杏仁核、海马及部分海马旁回,周边剂量17～20 Gy。结果随访46例,时间6～10年。术后5年按Engel分级：Ⅰ~Ⅱ级31例,Ⅲ级8例,Ⅳ级7例,有效率为67.4%。术后出现一过性头痛、记忆力下降20例,视野缺损12例,均在3~6个月内逐渐缓解。结论伽玛刀治疗相比传统开颅手术具有损伤轻、并发症少、长期有效率高等优点,是治疗颞叶内侧癫的方法之一。

Objective To explore the long-term therapeutic effect of gamma knife on mesial temporal lobe epilepsy（MTLE）.Methods Clinical data of 46 refractory MTLE patients treated by gamma knife were analyzed retrospectively.The gamma knife therapy was performed on the amygdala,hippocampus and a part of the parahippocampal gyrus with marginal dose ranged from 17 to 20 Gy.Results Forty-six patients were followed up for 6 to 10 years.The results were classⅠ to Ⅱ in 31 patients,class Ⅲ in 8 and class Ⅳ in 7 according to Engel classification 5 years after operation.The effective rate was 67.4%.Transient headache or memory deterioration occurred in 20 patients and visual field loss in 12 after operation,which relieved gradually in 3 to 6 months.Conclusions Compared with the traditional craniotomy,gamma knife therapy has the advantages of less injury,fewer complications and higher effective rate in a long duration,thus being one of treatment methods for MTLE.