经颞下沟选择性杏仁核海马切除术治疗内侧颞叶癫痫

目的探讨经颞下沟侧脑室入路选择性杏仁核海马切除术治疗内侧颞叶癫痫的手术方法、效果及并发症。方法确诊为药物难治性内侧颞叶癫痫的30例患者，在无框架神经导航指引下，经颞部锁孔开颅，显微镜下分开一小段颞下沟，切开侧脑室壁，进入颞角前外侧区，选择性切除杏仁核海马。结果30例患者术后随访至少2年时间（24—59个月），神经功能改善，无严重手术并发症，23例（76．7％）癫痫发作完全消失（EngelⅠ级）。结论经颞下沟侧脑室入路选择性杏仁核海马切除术是治疗内侧颞叶癫痫的有效方法，在神经导航辅助下手术创伤小，可妥善保护语言区和视放射，安全性高。

Selective Amygdalohippocampectomy via the Inferior Temporal Salons Approach for Treatment of Mesial Temporal Lobe Epilepsy

Objective To explore the surgical skills, effects and complications of selective amygdalohippocampectomy via the inferior temporal sulcus approach for the treatment of mesial temporal lobe epilepsy （MTLE）. Methods The selective amygdalohippoeampeetomy via the inferior temporal sulcus was performed under the guidance of a frameless neuronavigation system in 30 patients with intractable MTLE. All the patients were followed up from 24 to 59 months after the surgery. Results Of 30 patients, 23 belonged in Engel grade Ⅰ , 5 in grade Ⅱ and 2 in grade Ⅲ. The memory was improved after the surgery in 17 patients. No severe complications occurred in all the patients. Conclusions The selective amygdalohippocampectomy via the inferior temporal sulcus approach under the guidance of the frameless neuronavigation system is an effective method to treat intractable MTLE because it produces only little side injury and may provide a protection for the optic radiation and language area.