Wiebe Samuel
London Health Sciences Centre, University Campus, 339 Windermere Road, London, ON N6A 5A5, Canada.
Curr Neurol Neurosci Rep. 2004 Jul;4(4):315-20. doi: 10.1007/s11910-004-0058-9.
Uncontrolled epilepsy is associated with progressive cortical and hippocampal atrophy, substantial cognitive and psychosocial morbidity, and increased mortality. Seizure freedom is required to reverse such morbidity and mortality. Surgery is vastly superior to medical therapy for patients with chronic, refractory temporal lobe seizures, and is now the standard of care for these patients. On the other hand, the concept of early surgery requires further exploration and definition. Although there is no robust, direct evidence to support early epilepsy surgery, case series and cohort studies report an association between earlier surgery and better outcomes. The evidence for earlier epilepsy surgery is reviewed.
未经控制的癫痫与进行性皮质和海马萎缩、严重的认知和心理社会疾病以及死亡率增加有关。需要实现无癫痫发作才能扭转这种疾病和死亡率。对于患有慢性难治性颞叶癫痫的患者，手术治疗远优于药物治疗，目前已成为这些患者的标准治疗方法。另一方面，早期手术的概念需要进一步探索和界定。虽然没有有力的直接证据支持早期癫痫手术，但病例系列和队列研究报告了早期手术与更好的治疗效果之间的关联。本文对早期癫痫手术的证据进行了综述。
