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目的报道5例海马电刺激治疗(hippocampal stimulation,Hip-DBS)治疗颞叶癫痫(temporal lobe epilepsy,TLE)病例的临床疗效,并对已报道的Hip-DBS治疗TLE的文献中相关病例进行总结。方法回顾性收集2013年11月到2015年2月间进行Hip-DBS的5例TLE患者的临床资料、治疗方法及疗效,并在Pubmed中检索1995~2016年间发表的Hip-DBS治疗TLE的英文文献进行资料总结。结果本组5例Hip-DBS治疗病例均为曾行前颞叶切除术失败的双侧TLE患者,术后12m随访中,4例无癫痫发作,1例达到Engel II级癫痫控制,平均智商较术前提高5.00±3.08、平均生活质量均术前改善7.80±3.12,患者平均满意度91.80±5.07,无手术并发症发生。Pubmed中检索到无重复的文献12篇,共报道病例146例,无发作22(15.1%)例、有效73(50.0%)例,无效44(30.1%),加重7(4.8%)例。结论 Hip-DBS是治疗颞叶癫痫的有效方法,特别是对于前颞叶切除术治疗失败的双侧TLE,5例均有效。
Objective To report the clinical efficacy of hippocampal stimulation (Hip-DBS) in the treatment of temporal lobe epilepsy (TLE), and to summarize the reported cases of HLE-DBS in the treatment of TLE. Methods The clinical data, treatment and efficacy of five patients with Hip-DBS who underwent Hip-DBS between November 2013 and February 2015 were retrospectively collected. Pubmed was used to search for English version of Hip-DBS published in TLE from 1995 to 2016 Literature data summary. Results All the 5 cases of Hip-DBS treated in this study were bilateral TLE patients who had failed anterior temporal lobe resection. Among the 12-month follow-up, 4 cases had no epileptic seizures and 1 case achieved Engel class II epilepsy. The average IQ Preoperative increase of 5.00 ± 3.08, the average quality of life was improved preoperative 7.80 ± 3.12, the average patient satisfaction 91.80 ± 5.07, no surgical complications. A total of 12 unrelated articles were retrieved from Pubmed. Of the 146 cases reported, there were 146 reported cases without episodes (15.1%), 73 (50.0%) cases failed, 44 (30.1%) failed and 7 (4.8%) cases were worse. Conclusions Hip-DBS is an effective method for the treatment of temporal lobe epilepsy, especially for 5 cases of bilateral TLE with failed treatment of anterior temporal lobectomy.