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目的:探讨难治性颞叶癫痫(ITLE)的外科治疗方法和效果。方法:83例ITLE患者,术前均行EEG、MRI检查,其中23例行PET,19例行SPECT检查。经测定位后,行手术治疗。其中30例行标准前颞叶切除,37例行标准前颞叶切除+胼胝体切开,16例行病灶切除+致痫灶切除。术中应用皮层电极或深部电极进行检测,并在显微镜下操作。结果:满意47例(56.6%),显著改善23例(26.5%),良好13例(15.6%)。术后无明显并发症,效果良好。结论:手术是ITLE的主要治疗手段,海马硬化和微血管畸形可能是ITLE发生的主要原因。
Objective: To investigate the surgical treatment of intractable temporal lobe epilepsy (ITLE) and its effect. Methods: Totally 83 ITLE patients underwent EEG and MRI before operation. Twenty-three of them underwent PET and 19 underwent SPECT. After the measured bit, the line of surgery. Among them, 30 cases had standard anterior temporal lobectomy, 37 cases had standard anterior temporal lobectomy and corpus callosum incision, and 16 cases were performed excision and epileptogenic resection. Intraoperative use of cortical electrodes or deep electrode detection, and under the microscope. Results: Satisfactory in 47 cases (56.6%), significant improvement in 23 cases (26.5%) and good in 13 cases (15.6%). No significant postoperative complications, the effect is good. Conclusion: Surgery is the main treatment for ITLE. Hippocampal sclerosis and microvascular malformations may be the main causes of ITLE.