海马电刺激治疗颞叶癫痫(附5例报道及文献复习)

Hippocampal stimulation in patients with temporal lobe epilepsy(5 cases report and literatures review)

目的 报道5例海马电刺激治疗（hippocampal stimulation,Hip-DBS）治疗颞叶癫痫（temporal lobe epilepsy,TLE）病例的临床疗效,并对已报道的Hip-DBS治疗TLE的文献中相关病例进行总结。方法 回顾性收集2013年11月到2015年2月间进行Hip-DBS的5例TLE患者的临床资料、治疗方法及疗效,并在Pubmed中检索1995-2016年间发表的Hip-DBS治疗TLE的英文文献进行资料总结。结果 本组5例Hip-DBS治疗病例均为曾行前颞叶切除术失败的双侧TLE患者,术后12m随访中,4例无癫痫发作,1例达到Engel II级癫痫控制,平均智商较术前提高5.00±3.08、平均生活质量均术前改善7.80±3.12,患者平均满意度91.80±5.07,无手术并发症发生。Pubmed中检索到无重复的文献12篇,共报道病例146例,无发作22（15.1%）例、有效73（50.0%）例,无效44（30.1%）,加重7（4.8%）例。结论 Hip-DBS是治疗颞叶癫痫的有效方法,特别是对于前颞叶切除术治疗失败的双侧TLE,5例均有效。

Objective To reported surgical outcomes of 5 patients with temporal lobe epi- lepsy （TLE） who underwent hippocampal stimulation （Hip--DBS）,and review the published lit- eratures about Hip--DBS for the treatment of TI.E. Methods To retrospectively collect clinical data,surgical outcomes and complications of the 5 patients with Hip-DBS from November 2013 to February 2015, and review the English articles on hippocampus stimulation in patients with temporal lobe epilepsy searched on Pubmed. Results All of five patients in this cohort were bilat- eral TLE who had undergone unilateral ATL over 2 years before Hip-DBS. 12 months after Hip -DBS,4 cases reached seizure free,and 1 reduced over 90% seizure frequency. Mean intelligence quotient improved 5.00±3.08, and mean quality of life improved 7.80!3.12, and mean patients＂ satisfaction reached 91.80 ±5.07. twelve articles and 146 cases about Hip--DBS and TLE had been reported from 2002-2016,and there were 22（15. 1%） cases with seizure free,73（50.0%） with over 50% seizure reduction and 44（30. 1%） with less than 50% seizure reduction and 7 （4. 8%） patients with seizure increase. Conclusion Hip--DBS is a efficacy treatment in patients with TLE,especially in those with bilateral TLE who had undergone unilateral ATL.