颞叶癫痫:肿瘤性病变与海马硬化的手术治疗

Surgical treatment for temporal lobe epilepsy: mass lesions and hippocampus sclerosis

目的 探讨由肿瘤及海马硬化所致的颞叶癫痫的手术治疗。方法40例顽固性癫痫中,经MRI或CT诊断有19例内轴心性肿瘤性病变,有21例海马硬化,均行手术治疗,切除的标本进行组织学观察。结果 肿瘤性病变19例均作了肿瘤全切除加海马、杏仁核切除,海马硬化21例均作选择性海马、杏仁核切除术。40例中35例随访,随访时间为术后3个月至1年,5例失去联系。癫痫完全解除的有30例,5例仍需依赖药物治疗。结论 海马硬化是颞叶癫痫的主要原因,手术切除疗效满意。

Objective To study the surgery of temporal lobe epilepsy caused by mass lesions or hippocampus sclerosis. Methods Fourty patients of intractable epilepsy, of which 19 had intraaxial temporal neoplasm and 21 had hippocampus sclerosis diagnosed by MRI or CT, accepted surgical excision. The removed part in the patients with temporal neoplasm included mass lession, hippocampus, and amygdala. The removed part in the patients with hippocampus Sclerosis included hippocampus and amygdala. The histologic changes were observed in the excised samples. Results Thirty - five of 40 cases were followed up. The epilepsy was relieved completely in 30 cases. The other 5 cases were still dependent on drugs, but the epilepsy was relieved obviously. Conclusion Hippocampus sclerosis is the predominant factor of temporal lobe epilepsy, and the effect of surgical excision is satisfactory.