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目的探讨手术治疗颞叶癫痫的疗效及并发症。方法皮层电极及深部电极引导下手术治疗69例颞叶癫痫,其中前颞叶+海马杏仁核切除术67例,选择性海马杏仁核切除术2例。术前行PET、SPECT、MRI、EEG检查。结果 69例术后随访1~7.6年,满意63例,显著改善2例,良好1例,无效3例,有效率95.7%。其中癫痫完全消失60例,占87%。无死亡,暂时性偏瘫2例,占2.9%,轻度同向视野缺损6例,占8.7%,硬膜外血肿1例,记忆力减退3例。结论手术治疗颞叶癫痫的效果好;疗效与病例的选择及致癫灶的准确定位有关;部分并发症与手术技巧有关。
Objective To investigate the efficacy and complications of surgical treatment of temporal lobe epilepsy. Methods 69 cases of temporal lobe epilepsy were treated by cortical electrode and deep electrode. There were 67 cases of anterior temporal lobe + hippocampus almond excision and 2 cases of selective hippocampus almond excision. Preoperative PET, SPECT, MRI, EEG examination. Results 69 cases were followed up from 1 to 7.6 years, 63 were satisfied, 2 were significantly improved, 1 was good, 3 were ineffective, and the effective rate was 95.7%. Epilepsy completely disappeared in 60 cases, accounting for 87%. No death, temporary hemiplegia in 2 cases, accounting for 2.9%, mild with the same field of vision defect in 6 cases, accounting for 8.7%, 1 case of epidural hematoma, memory loss in 3 cases. Conclusions Surgical treatment of temporal lobe epilepsy is effective. The curative effect is related to the selection of cases and the accurate location of epileptogenic lesions. Some complications are related to surgical skills.