Fish D, Andermann F, Olivier A
Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada.
Neurology. 1991 Nov;41(11):1781-4. doi: 10.1212/wnl.41.11.1781.
Twenty patients with small, indolent, relatively inaccessible posterior temporal or extratemporal lesions had complex partial seizures presumably related to anterior and inferomesial temporal lobe epileptic activity. All underwent anterior temporal corticectomies, and in six the resection was extended at a second operation. There was sclerosis of mesial temporal structures in seven of the surgical specimens. Two patients became seizure free for more than 2 years; three others showed more than 95% reduction in seizure frequency, and five had moderate (greater than 50%) reduction. While cessation of seizures or improved control may occur following this surgical strategy, the results are strikingly inferior to those obtained when the lesion, as well as the epileptogenic area, can be resected. Review of this group of patients suggests that the lesion should be included in the resection if at all possible.
20例患有小的、进展缓慢的、相对难以接近的颞叶后部或颞叶外病变的患者发生复杂部分性癫痫发作，推测与颞叶前部和内侧下部癫痫活动有关。所有患者均接受了前颞叶皮质切除术，其中6例在第二次手术时扩大了切除范围。手术标本中有7例存在颞叶内侧结构硬化。2例患者癫痫发作停止超过2年；另外3例癫痫发作频率降低超过95%，5例癫痫发作频率中度降低（超过50%）。虽然采用这种手术策略可能会使癫痫发作停止或控制改善，但结果明显不如能够切除病变以及癫痫源区时所获得的结果。对这组患者的回顾表明，只要有可能，病变应包含在切除范围内。
