前颞叶内侧切除术治疗颞叶内侧型癫痫

目的探讨前颞叶内侧切除术治疗颞叶内侧型癫痫的治疗效果。方法21例顽固性颞叶癫痫患者,采用无框架神经导航辅助,经颞中回行前颞叶内侧切除术,切除前颞叶、杏仁核及海马。采用分级量表进行针对癫痫发作控制效果的评价。结果21例术后随访6～29个月,神经功能均改善,无严重手术并发症。16例（76%）癫痫发作完全消失（EngelⅠ级）,3例（16%）癫痫发作极少（EngelⅡ级）,2例（8%）癫痫发作减少（EngelⅢ级）。结论前颞叶内侧切除术是治疗颞叶癫痫的有效方法。神经导航辅助下手术彻底切除杏仁核及海马,避免了语言区和视放射的损伤。

Temporal lobectomy via the anterolateral approach for treatment of mesial temporal lobe epilepsy

Objective To explore the surgical skills,effects and complications of temporal lobectomy via the anterolateral approach for the treatment of mesial temporal lobe epilepsy（MTLE）.Methods The temporal lobectomy via the anterolateral approach was performed under the guidance of a frameless neuronavigation system in 21 patients with intractable MTLE.All the patients were followed up from 6 to 29 months after the surgery.Results In 21 patients,16（76%） cases belonged in Engel grade Ⅰ,3（16%）cases in gradeⅡ and 2（8%） cases in grade Ⅲ. The neuro-function was improved after the surgery in 16 patients. No severe complications occurred in all the patients. Conclusions The temporal lobectomy via the anterolateral approach under the guidance of the frameless neuronavigation system is an effective method to treat intractable MTLE because the volume of medial hippocampus and amygdala removed are extremely variable. It also provide a protection for the optic radiation and language area.