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目的研究双侧颞叶癫痫(bitemporal lobe epilepsy,BTLE)的外科治疗方法。方法 l4例BTLE患者经临床症状、视频脑电监测(VEEG)、头颅磁共振(MRI)、磁共振波谱(MRS)、正电子发射断层显像-计算机断层显像(PET-CT)、颅内电极脑电图(IEEG)、术中皮层脑电(ECoG)和深部脑电(DEEG)检查,发现双侧颞叶存在各自独立的致痫灶。对于一侧杏仁核海马复合体及一侧和/或双侧颞叶新皮层中的致痫灶,分别给予选择性杏仁核海马切除术(SAH)和/或多处皮层热灼术(BCFC)联合治疗。结果随访6~24个月,按照Engel的疗效判断标准:l级6例,Ⅱ级3例,Ⅲ级3例,Ⅳ级2例。术后未发生永久性并发症。结论采用选择性杏仁核海马切除术和皮层热灼术联合治疗BTLE是行之有效的。
Objective To study the surgical treatment of bitemporal lobe epilepsy (BTLE). Methods Twenty-four patients with BTLE were divided into two groups according to clinical symptoms, VEEG, MRI, MRS, PET-CT, intracranial Electrode EEG, intracortical ECoG and DEEG showed that there were separate epileptogenic lesions in bilateral temporal lobe. Selective amygdala hippocampus (SAH) and / or multiple cortical cauterization (BCFC) were given to one side of the amygdala hippocampus and to the epileptogenic zone in one or both temporal cortex neocortex, respectively Combination therapy. Results The follow-up ranged from 6 to 24 months. According to Engel’s curative effect, 6 cases were grade l, 3 were grade II, 3 were grade III and 2 were grade IV. No postoperative complications occurred. Conclusions The treatment of BTLE with selective amygdala hippocampus and cortical cauterization is effective.