双侧颞叶癫痫的立体定向治疗初探%3a附1例报告.pdfVIP

双侧颞叶癫痫的立体定向治疗初探：附1 例报告 海军总医院全军神经外科中心 赵全军 田增民 吴朝辉 林鸿 尹丰 郝秋星 王红 肖霞 王福莉 李红玉 于雪 [摘要]目的为探索治疗双颞叶癫痫的最佳治疗方法。5例被证实为双颞叶癫痫患者在深 部电极引导下实施了双侧海马杏仁复合体射频毁捐术。随访 1年以上，按 Engel分级，I 级2 例；Ⅱ、Ⅲ级各1例；IV 级 1 例。对其中 1 例进了详细报导。方法 首先采用多导长程视频脑 电加偶极子定位检查提示为双颞痫性放电，而后经深部电极埋藏提示为双颞独立起源灶，遂行 双侧海马杏仁复合体毁损术。结果 术后随访2.5年，无癫痫发作，手术前后及随访期神经心理 学检查未见永久的记忆损害。结论 由于严重的记忆损害，双颞叶癫痫无法实施切除性手术，立 体定向外科是减少发作的可行性手段，但应对更多的病例实施神经心理学检查以获得确切结果。 [关键词]立体定向，双颞叶癫痫，外科治疗，神经心理学检查 中图分类号:R745.1 The primary study of the stereotactic treatment to bilateral temporal lobe epilepsy：1 case report Zhao Quanjun, Tian Zengmin, Wu Zhaohui, et al. .Department of Neurosurgery, Navy General Hospital of PLA, Beijing, 100037 [ABSTRACT] Objective To search a best method for the treatment of bilateral temporal lobe epilepsy. 5 cases who were confirmed to be bilateral temporal lobe epilepsy were experienced the radiofrequency of bilateral amygdalohippocampal coagulations under the guiding of deep sited electrode bilaterally. The follow-up-time was more than 1 year. According to Engels classification, 2 cases were in class I, the other 2 cases were in class Ⅱand Ⅲrespectively, and the rest 1 case was in class IV. 1 case is reported in detail. Methods The long term video EEG and bipolar analysis showed bilateral temporal lobe discharge. Deep sited electrode monitoring indicated bilateral independent origin focus. So amygdalohippocampal coagulations were made. Results The follow -up-time was 2.5 years. No seizure occurred . Preoperative, postoperative and the follow-up-time neuropsychological examinations were performed and no long term memorial deficits were found. Conclusions Since resective surgery is not available to bilateral temporal lobe epilepsy because of the severe loss of memory, stereotactic surgery