颞叶新皮质癫痫手术的疗效分析

目的分析总结颞叶新皮质癫痫患者临床特征、术前评估、手术方法和疗效。方法对36例颞叶新皮质癫痫行神经电生理、MRI，正电子发射计算断层显像计算机体层扫描（PET—CT）定位，术中皮层电极和深部电极描记，联合采用不同术式以及术后随访6个月至2年的疗效观察。结果疗效按谭启富的标准分类：Ⅰ级12例，Ⅱ级11例，Ⅲ级8例，Ⅳ级5例，Ⅴ级0例。病理报告：胶质增生23例；微小血管畸形5例；灰质异位1例，无异常发现7例。无手术致残和死亡。结论联合采取不同术式，如：行海马及杏仁核部分切除，对颞叶新皮质癫痫可达到良好的治疗效果，且无严重手术并发症。

Surgical treatment of neocortical temporal lobe epilepsy

Objective To explore the clinical features, the pre-operative evaluation, surgical methods and outcome of neocortieal temporal lobe epilepsy （NILE）. Methods Epileptogenic focus were exactly localized by electroencephalogram （EEG）, magnetic resonance imaging （ MRI ）, and positron emission tomography （PET）. Intraoperative electrocorticography （ECOG） and depth EEG （DEEG） of 36 patients with NTLE were recorded. All the patients were followed up from 6 months to 2 years, Results According to Tang standard there were 13 eases of grade I, 11 cases of grade 11, 8 eases of grade III , and 4 eases of grade IV. All the cases were performed pathological examination： 23 eases of gliosis, 5 cases of vascular malfornmtion, l case of cortical heterotopia, and 7 cases of no changes. No dead ease or the operation-related disabled case. Conclusion Different surgical methods, such as, hippocampus and almond-pit partial resection, contribute to a good outcome of surgery for neocortical temporal lobe epileosy （NTLE）.