手术治疗颞叶癫痫的远期疗效及影响因素分析

Assessing the influence factors and long-term results of surgery on the temporal lobe epilepsy

目的探讨手术治疗颞叶癫痫的远期疗效及影响因素。方法皮层电极及深部电极引导下手术治疗59例颞叶癫痫,其中前颞叶＋海马杏仁核切除术57例,选择性海马杏仁核切除术2例。术后进行长期追踪术后随访6-16年,回顾性研究影响患者预后的因素。结果癫痫控制满意44例,显著改善6例,良好3例,无效6例,有效率89.8%。其中癫痫完全消失36例,占61%。复发4例,无死亡病例,记忆力减退3例,精神症状2例。结论手术治疗颞叶癫痫安全有效,但存在远期复发的可能;少数患者远期可能出现记忆力减退及精神症状等;疗效与病例的选择及致癫灶的准确定位等因素有关。

Objective This study aims to assess the effect factors and long-term results of surgery on the temporal lobe epilepsy.Methods We studied 59 patients with temporal lobe epilepsy who underwent epilepsy surgery：anterior temporal lobectomy for 57cases;selective amygdalohippocampectomy for 2cases,with the aid of cortical and deep electrode,they were followed up for 6-16years,the prognostics factors for these cases were also assessed.Results Satisfactory outcome on 44 cases,improved significantly on 6cases,mild recovery on 3cases,no improved on 6cases,89.9% of cases are improved effectively,61% of case became seizure-free,epilepsy relapsed in 4cases,no case died,3cases with memory deficits,2case with psychiatric symptoms.Conclusion Long-term follow-up of patients with temporal lobe epilepsy demonstrates surgery is safe and effective in seizure improvement,but few cases will develop the memory deficits and psychiatric symptoms at long follow-up,the outcome are associated with the indication of the surgery and location the epilepsy.