文档介绍：颞叶癫痫的手术疗效
Of 168 patients included, 108 (%) underwent stereoelectroencephalography, 131 (78%) had hippocampal sclerosis, 149 suffered from unilateral temporal lobe epilepsy (%), one from bitemporal epilepsy (%) and 18 (%) from temporal plus epilepsy. The probability of Engel class I outcome at 10 years of follow-up was % (95% CI: –) for the entire cohort, % (95% CI: –) for unilateral temporal lobe epilepsy, and % (95% CI: –) for temporal plus epilepsy.
Multivariate analyses demonstrated four predictors of seizure relapse:
※ temporal plus epilepsy (P<),
※ postoperative hippocampal remnant (P = ),
※ past history of traumatic or infectious brain insult (P = ),
※ secondary generalized tonic-clonic seizures (P = ).
颞叶附加癫痫的简介
The term of temporal ‘plus’ (Tt) epilepsies has recently been suggested (Ryvlin and Kahane, 2005) to describe specific forms of seizures of multilobar origin which are characterized by the involvement of a complex epileptogenic network including the temporal lobe and the closed neighboured structures, such as the orbito-frontal cortex, the insula, the frontal and parietal operculum and the temporo–parieto–occipital junction.
In a depth EEG study aiming at verifying the role of the perisylvian cortex in seizures involving the temporal lobe, Kahane et al. (2001) showed that six of the seven patients in whom seizures arose from temporal and suprasylvian opercular cortices, and in whom an adequate temporo-perisylvian resection could be achieved, were totally seizure-free after surgery.
Temporal lobe surgery alone was unsuccessful in the two temporo-insular cases of Isnard et al. (2004), since it allowed them to suppress the seizures of temporal lobe origin, but not those which arose from the insula.
Moreover, anterior temporal resection did not benefit the patients with ictal temporo-parietal symptoms