杏仁核海马立体定向射频热凝毁损术治疗内侧颞叶癫痫的临床研究

The amygdala damaged hippocampus stereotactic radiofrequency thermal coagulation treatment of the clinical research of the medial temporal lobe epilepsy

目的分析采用杏仁核海马立体定向射频热凝毁损术（SAHE）治疗内侧颞叶癫痫的方法、癫痫控制情况及神经心理学功能影响,评估SAHE的效果及安全性。方法选取48例内侧颞叶癫痫行外科手术治疗患者为研究对象,分析其一般资料、SAHE治疗方法及术后癫痫发作消失率、神经心理学功能术后检测情况。结果手术均顺利完成,术后随访6个月~2年,癫痫完全控制率为52.1%,治疗显效率为75.0%,总有效率为89.6%,术后11例（22.9%）患者出现轻度头痛,9例（18.8%）患者术后出现低热,均为给予特殊治疗,未影响后续治疗,后1周患者PIQ、VIQ、MQ有所下降,但是在之后的随访中发现患者术后6个月在神经心理功能各维度评测结果均已恢复至术前水平,术后1周患者PIQ、VIQ、MQ有所下降,但是在之后的随访中发现患者术后6个月在神经心理功能各维度评测结果均已恢复至术前水平。结论 SAHE对内侧颞叶癫痫的治疗效果显著,能够有效的减少术后癫痫发作次数,术后早期会对患者的语言、操作智商、记忆力有一定影响,但长远观察可恢复正常,安全性良好,值得临床推广应用。

Objective To observe the analysis using the amygdala damaged hippocampus stereotactic radiofrequency thermal coagulation technique（SAHE）to treat the method of the medial temporal lobe epilepsy,epilepsy and neuropsychological influence function,evaluate the effect and safety of SAHE.Methods 48 cases of medial temporal lobe epilepsy surgery patients as the research object,analyzes the general data,SAHE treatment and postoperative seizures disappeared rate,postoperative neuropsychological function testing.Results The operation are completed smoothly,postoperative follow-up of 6 months to 2years,completely control epilepsy was 52.1%,the treatment efficiency was 75.0%,total effective rate was 89.6%,postoperative,11cases（22.9%）patients experienced mild headache,9cases（18.8%）patients had low thermal,are given special treatment,no impact on the follow-up treatment,1week after patients PIQ,VIQ,MQ declined,but after 6months of follow-up found that patients with postoperative in every dimension of neuropsychological function recovered to preoperative levels evaluation results have been,with 1week after PIQ,VIQ,MQ declined,but after 6months of follow-up found that patients with postoperative in every dimension of neuropsychological function recovered to preoperative levels evaluation results have been.Conclusion SAHE of medial temporal lobe epilepsy treatment effect significantly,can effectively decrease The Times of postoperative seizures in patients with early postoperative will have effects on language,operation intelligence,memory,but longterm observation can be back to normal,security is good,worthy of clinical popularization and application.