Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
Epilepsia. 2010 Jun;51(6):1097-100. doi: 10.1111/j.1528-1167.2010.02538.x. Epub 2010 Mar 18.
Medically intractable epilepsy (MIE) resulting from postinfectious etiologies requiring surgery have been uncommonly reported. A series of 28 cases are presented (hospital prevalence 5.7%). The mean duration of epilepsy prior to surgery was 8.2 +/- 2.1 years. The mean time of onset of epilepsy after central nervous system infection was 1.4 +/- 0.9 years (range 0-19 years). The pathologies included postpyogenic meningitic/encephalitic sequel (8), neurocysticercosis (6), tuberculomas/posttuberculous etiology (4), postpyogenic abscess of otogenic etiology (4), posttraumatic abscess-related gliosis (2), and gliosis of unknown infectious etiology (4) cases. Surgery included mesial temporal (11), lateral temporal (4), frontal (9), parietal (2) resections and hemispherotomy (1). Hippocampal sclerosis was seen in nine cases (4 neurocysticercosis) and this occurred in younger persons as compared to neocortical epilepsies. Good outcome (Engel class I and II) was seen in 23 of 28 cases (Engel class I in 17).
由感染后病因引起的药物难治性癫痫（MIE）需要手术治疗的情况并不常见。本文报告了一系列 28 例病例（医院患病率为 5.7%）。手术前癫痫的平均持续时间为 8.2±2.1 年。中枢神经系统感染后癫痫发作的平均时间为 1.4±0.9 年（范围 0-19 年）。病变包括化脓性脑膜炎/脑炎后（8 例）、神经囊虫病（6 例）、结核瘤/结核后病因（4 例）、耳源性化脓性脓肿（4 例）、创伤后脓肿相关胶质增生（2 例）和不明原因感染性病因的胶质增生（4 例）。手术包括内侧颞叶（11 例）、外侧颞叶（4 例）、额叶（9 例）、顶叶（2 例）切除术和半脑切除术（1 例）。9 例（4 例神经囊虫病）可见海马硬化，与新皮质癫痫相比，这种情况发生在更年轻的人群中。28 例中有 23 例（17 例为 Engel Ⅰ级）预后良好（Engel Ⅰ和Ⅱ级）。
