Malikova Hana, Vojtech Zdenek, Liscak Roman, Prochazka Tomas, Vymazal Josef, Mareckova Iva, Kalina Miroslav, Dbaly Vladimir, Keller Jiri, Vladyka Vilibald
Department of Radiology, Charles University, Prague, Czech Republic.
Stereotact Funct Neurosurg. 2010;88(1):42-50. doi: 10.1159/000268741. Epub 2009 Dec 24.
We compared stereotactic radiofrequency amygdalohippocampectomy (SAHE) with microsurgical amygdalohippocampectomy (AHE) in a group of 33 patients with mesial temporal lobe epilepsy in terms of hippocampal and amygdalar volume reductions and clinical outcome. In 23 subjects treated by SAHE, the hippocampal volume decreased by 58.0% (20.0; median, quartile range), with p = 10(-4), and the amygdalar volume decreased by 55.2% (23.8), with p = 10(-4). Two years after SAHE, 74% of patients were classified as class I, 22% as class II and 4% as class III. In 10 subjects treated by AHE, 83.5% (11.2) of the hippocampal and 53.1% (53.9) of the amygdalar volumes were removed (p = 0.05 and p = 0.005, respectively). Two years after the operation, 50% of the subjects were classified as class I, 30% as class II and 10% as class III and IV. To conclude, SAHE leads to a similar reduction of the amygdalar volume but to a significantly lower reduction of the hippocampal volume than AHE. The clinical outcome of SAHE is comparable with that of AHE.
我们比较了立体定向射频杏仁核海马切除术（SAHE）与显微外科杏仁核海马切除术（AHE）在33例内侧颞叶癫痫患者中的疗效，评估指标包括海马和杏仁核体积缩小情况以及临床结局。接受SAHE治疗的23例患者中，海马体积减少了58.0%（中位数为20.0，四分位数间距），p = 10⁻⁴，杏仁核体积减少了55.2%（23.8），p = 10⁻⁴。SAHE术后两年，74%的患者被归类为I级，22%为II级，4%为III级。接受AHE治疗的10例患者中，海马体积切除了83.5%（11.2），杏仁核体积切除了53.1%（53.9）（p分别为0.05和0.005）。术后两年，50%的患者被归类为I级，30%为II级，10%为III级和IV级。总之，SAHE导致的杏仁核体积缩小程度与AHE相似，但海马体积缩小程度明显低于AHE。SAHE的临床结局与AHE相当。
