Sperling M R, O'Connor M J, Saykin A J, Phillips C A, Morrell M J, Bridgman P A, French J A, Gonatas N
Comprehensive Epilepsy Center, Graduate Hospital, Philadelphia, PA 19146.
Neurology. 1992 Feb;42(2):416-22. doi: 10.1212/wnl.42.2.416.
We report the results of a protocol for choosing candidates for temporal lobectomy using a standard battery of objective tests without intracranial electrodes. We assigned each test a level of importance, and an algorithm was used to determine whether temporal lobectomy could be performed. Fifty-one patients (total pool, 103 patients) met protocol requirements and had an anterior temporal lobectomy with a mean follow-up of 39.4 months (range, 21 to 64 months), most remaining on anticonvulsant therapy. Eighty percent are seizure free, 12% have less than 3 seizures per year or only nocturnal seizures, and 8% have greater than 80% reduction in seizure frequency. One-third of patients who failed protocol criteria did not have temporal lobe seizures when studied with intracranial electrodes. We analyzed and modified the algorithm after comparing these patients with others who were poor candidates for temporal lobectomy. We conclude that this protocol is effective and recommend using such an objective algorithm.
我们报告了一项使用标准客观测试组合（不使用颅内电极）选择颞叶切除术候选者的方案结果。我们为每项测试赋予了一个重要性水平，并使用一种算法来确定是否可以进行颞叶切除术。51名患者（总样本量为103名患者）符合方案要求，接受了前颞叶切除术，平均随访39.4个月（范围为21至64个月），大多数患者仍在接受抗惊厥治疗。80%的患者无癫痫发作，12%的患者每年癫痫发作少于3次或仅在夜间发作，8%的患者癫痫发作频率降低超过80%。在方案标准不达标但经颅内电极检查无颞叶癫痫发作的患者中，有三分之一属于这种情况。在将这些患者与其他颞叶切除术不佳候选者进行比较后，我们对算法进行了分析和修改。我们得出结论，该方案是有效的，并建议使用这样一种客观算法。
