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目的探讨海马有病损的颞叶内侧癫痫的手术价值。方法回顾性分析经手术治疗的15例伴有海马病损的颞叶内侧癫痫患者。均经详细了解发作症状学、附加蝶骨电极的长程视频脑电图及颅脑磁共振等检查;经正规而详尽的术前评估,行标准前颞叶切除术,术后随访至少半年以上。结果术后依据Engel分级,显效(Ⅰ级和Ⅱ级)80.0%、好转(Ⅲ级)20.0%、无效(Ⅳ级)0.0%。手术疗效与单侧或双侧异常放电(一侧优势)相比、与异常放电区域局限于蝶骨及前中颞或扩散至额叶相比、与异常放电起源于蝶骨或起源于蝶骨及前中颞相比差异均无统计学意义。结论标准前颞叶切除是治疗颞叶内侧癫痫的有效方法。
Objective To investigate the surgical value of temporal lobe medial epilepsy with hippocampal lesions. Methods A retrospective analysis of 15 cases of temporal lobe medial epilepsy with hippocampal lesion was performed. After a detailed understanding of the onset symptoms, additional sphenoid electrode long-range video EEG and brain magnetic resonance imaging; formal and detailed assessment of preoperative, standard anterior temporal lobectomy, postoperative follow-up at least six months or more. Results According to Engel classification, 80.0% (grade Ⅰ and Ⅱ), 20.0% (grade Ⅲ), and 0.0% (grade Ⅳ) were improved. Surgical efficacy and unilateral or bilateral abnormal discharge (one side advantage) compared with the abnormal discharge area confined to the sphenoid and anterior temporal or diffuse to the frontal compared with the abnormal discharge originated in the sphenoid or originated in the sphenoid There was no significant difference between the two groups Conclusion The standard anterior temporal lobe resection is an effective method for the treatment of medial temporal lobe epilepsy.