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外科手术是难治性颞叶癫痫安全有效的标准治疗方式。其中颞叶内侧癫痫(Mesial temporal lobe epilepsy MTLE)是最常见、最适合外科手术治疗的癫痫综合征,术后癫痫发作控制满意率(Engel I、II级)可达70%以上,大部份患者的生活质量得到显著改善。随着近年来神经影像学、神经电生理学等诊断技术的迅猛发展,既往许多潜在的适宜手术治疗的MTLE患者得到确诊并接受手术治疗,但术后患者近期及远期疗效并未得到显著提高。本综述立足于近年国外神经影像学、神经病理学及实验室基础性的研究结果,探讨影响MTLE术后疗效的相关因素及其临床意义。
Surgery is a safe and effective standard treatment for refractory temporal lobe epilepsy. Among them, mesial temporal lobe epilepsy (MTLE) is the most common and most suitable surgical treatment of epilepsy syndrome. Postoperative seizure control satisfaction rate (Engel I, grade II) can reach more than 70%. Most of the patients The quality of life has been significantly improved. With the rapid development of diagnostic techniques such as neuroimaging and neuroelectrophysiology in recent years, many potential MTLE patients with appropriate surgical treatment have been diagnosed and surgically treated, but the short-term and long-term effects of postoperative patients have not been significantly improved. Based on the findings of foreign neuroimaging, neuropathology and laboratory basic research in recent years, this review summarizes the related factors and their clinical significance of the curative effect after MTLE.