术中皮层脑电监测下显微手术治疗颞叶癫痫32例临床分析

Clinical analysis of 32 cases of temporal lobe epilepsy treated by microsurgery under intraoperative cortical EEG monitoring

目的探讨术中皮层脑电监测下经改良翼点入路显微手术治疗颞叶癫痫的效果。方法回顾性分析2012年1月至2021年6月商丘市第一人民医院神经外科收治的32例颞叶癫痫手术患者的临床资料,所有患者均在皮层脑电监测下经改良翼点入路显微手术切除致痫灶。结果术后随访半年至6年,按谭氏分类法评价手术效果,满意25例(78.1%,25/32)、显著改善3例(9.4%,3/32)、效果良好4例(12.5%,4/32)。术后出现同向性偏盲1例(3.1%),无手术死亡。结论术中皮层脑电监测下经改良翼点入路显微手术切除致痫灶是治疗颞叶癫痫安全有效的方法。

Objective To investigate the effect of microsurgery by modified pterional approach in the treatment of temporal lobe epilepsy under intraoperative cortical encephalon electricity graph(EEG)monitoring.Methods The clinical data of 32 patients with temporal lobe epilepsy who were admitted to the Department of Neurosurgery of Shangqiu First People's Hospital from January 2012 to June 2021 were retrospectively analyzed,all patients underwent microsurgical resection of epileptogenic foci by modified pterional approach under cortical EEG monitoring.Results The postoperative follow-up was from half a year to 6 years.According to the Tan's classification,25 cases(78.1%(25/32))of seizures disappeared completely,3 cases(9.4%(3/32))of seizures decreased by more than 75%,and 4 cases(12.5%(4/32))of seizures decreased by more than 50%.Isotropic hemianopia occurred in 1 case(3.1%)after operation,and there was no operative death.Conclusion Microsurgical resection of epileptogenic foci through modified pterional approach under intraoperative cortical EEG monitoring was a safe and effective method for the treatment of temporal lobe epilepsy.