MRI阴性的颞叶癫痫的外科治疗

目的 总结MRI阴性的颞叶癫痫的手术疗效.方法 对2004年4月至2009年12月间行前颞叶切除的并且MRI为阴性的32例颞叶癫痫患者的资料进行回顾性分析.包括术前检查、手术方式、术后病理及手术疗效.结果 Engel Ⅰ级为21例,占66％；EngelⅡ级为4例,占12％,EngelⅢ～Ⅳ级为7例,占22％,其中头皮视频脑电图痫波位于一侧颞叶的手术效果较好,86％可达到Engel Ⅰ级.结论 对MRI阴性的颞叶癫痫术前评估要更加全面,如检查结果趋于一致,手术效果良好,特别是癫痫样放电起源于一侧颞叶的手术效果更佳.

Surgical treatment of temporal lobe epilepsy with non - lesional MRI

Objective To determine the long- term efficacy of anterior temporal lobectomy for medically refractory temporal lobe epilepsy in patients with non- lesional magnetic resonance imaging (MRI).Methods The clinical data of 32 patients with non - lesional modem seizure protocol MRI who underwent anterior temporal lobectomy for treatment of medically refractory epilepsy from April 2004 to December 2009 at BeiJing SanBo Epilepsy Center were collected retrospectively.The preoperative examinations,surgical methods,results of pathological test and surgical efficacy of these patients were analyzed.Postoperative seizure freedom was determined by ANOVA analysis.Results Engel class Ⅰ outcomes (free of disabling seizures) were observed in 66％ (21 of 32) patients,class Ⅱ in 12％ (4 of 32) and Engel class Ⅲ ～ Ⅳ in 22％ (7 of 32).Better efficacy was observed in patients whose epileptiform discharges in scalp Vedio -EEG (vedio electroencephalogram) were characterized within unilateral temporal lobe,and 86％ of these patients had Engel class Ⅰ outcomes.Conclusions In carefully selected patients with temporal lobe epilepsy and non -lesional MRI,anterior temporal lobectomy could often render patients free of disabling seizures with the detection of concordant abnormalities,especially for patients with epileptiform discharge confined within unilateral temporal lobe.