一侧混合性颞叶癫痫的联合微创手术治疗  

A combination of minimally invasive procedures for unilateral mixed temporal lobe epilepsy

作　　者：杨卫东[1] 毓青[2] 浦佩玉[1] 张建宁[1] 杨树源[1] 

机构地区：[1]天津医科大学总医院神经外科,天津300052 [2]天津医科大学总医院神经内科癫痫专科,天津300052

出　　处：《立体定向和功能性神经外科杂志》2007年第3期137-140,共4页Chinese Journal of Stereotactic and Functional Neurosurgery

基　　金：天津市卫生局科技基金项目(编号:04KZ25);天津市科技成果(编号:津20060727)

摘　　要：目的探讨一侧混合性颞叶癫痫联合微创手术治疗的方法。方法16例顽固性颞叶癫痫患者,经临床症状、长程视频脑电监测(V-EEG)、头颅CT、MRI、磁共振波谱(MRS)、正电子发射断层显像-计算机断层显像(PET-CT)、脑磁图(MEG)和术中皮层脑电(ECoG)以及深部脑电(DEEG)检查,发现在一侧颞叶海马和颞叶新皮层中存在着各自独立的致痫灶,诊断为一侧混合性颞叶癫痫,分别给予立体定向杏仁核海马毁损(SAHT)和多处软膜下横切术(MST)联合治疗。结果随访6～32个月,按照Engel的疗效判断标准:I级7例,II级4例,III级4例,IV1例。术后未发生永久性并发症。结论采用联合微创手术方法治疗一侧混合性颞叶癫痫,是安全有效的。Objective To explore a combination of minimally invasive surgical procedures for unilateral mixed temporal lobe epilepsy. Methods 16 patients with intractable temporal lobe epilepsy who have independent epileptogenic foci in the hippocampus and the neocortex of unilateral temporal lobe was diagnosed by clinical features, video-electroencephalogram （V-EEG）, computed tomogrphy（CT）, magnetic resonance imaging （MRI）, magnetic resonance spectroscopy （MRS）, positron emission tomography--computed tomography （PET-CT）, magnetoencephalography （MEG）, neuropsychology, and intraoperative electrocoticography （ECoG） and depth EEG （DEEG）. All cases were treated with stereotactic amygdalohippocampotomy （SAHT） and multiple subpial transection （MST）, respectively. Results A series of patients were followed-- up for 6-32 months. To evaluate according to Engel＇s cure standard： Grade Ⅰ in 7 cases; Grade Ⅱin 4 case; Grade Ⅲ in 4 cases; Grade Ⅳ in 1 case. Postoperation, there are no permanent complications. Conclusion A combination of minimally invasive surgical procedures is safe and effective in controlling unilateral mixed temporal lobe epilepsy.

关 键 词：颞叶癫痫 立体定向杏仁核海马毁损术 多处软膜下横切术 

分 类 号：R739.41[医药卫生—肿瘤]