选择性海马杏仁核切除术治疗顽固性颞叶癫痫

目的 探讨选择性涨马杏仁核切除术治疗颞叶癫痫的机理、适应征及手术入路。方法 对２０例经ＥＥＧ和ＭＲ诊断为颞叶内侧癫痫病例实施海马杏仁核切除。结果 １０例颞叶癫痫患接受经颞底入路选择性涨马杏仁核切除，另１０例接受经颞极入路海马杏仁核切除。术后随访，所有患癫痫发作控制满意，无手术并发症发生。结论 选择性海马杏仁２核切中通过消除癫痫灶或阻断癫痫环路来治疗颞叶癫痫，深部电极提示有颞叶内侧放电或ＭＲ发现

Selective Amygdalohippocampectomy for Intractable Temporal Epilepsy

Objective The purpose of this paper was to evaluate the therapeutic mechanism, operative indications and surgical approach of selective amygdalonippocampectomy (SLE) in the treatment of intractable temporal epilepsy. Method Data from 20 patients who diagnosed as having intractable temporal epilepsy by EEG and MR and received SLE were analyzed retrospectively. Results Trans-zygomaticotemporal base approach was adopted in 10 patients and trans-temporal pole approach for another 10 patients. Follow-up results demonstrated that satisfactory outcomes were obtained in all of these cases. No untoward surgical complication was observed. Conclusions By removing off the epileptic foci or cutting off the epileptic cycle, SLE could be used to treat the patients with intractable epilepsy. It was also suitable for those whose depth EEGs were found to have epileptiform discharges or sclerotic changes in the hippocampus on MR imaging. Trans-zygomaticotemporal base approach might be relatively safe for this surgery.