Plangger C, Seiwald M, Zechberger J
Universitätsklinik für Neurochirurgie, Innsbruck.
Wien Klin Wochenschr. 1990 Sep 28;102(18):538-43.
We are witnessing a renaissance of the surgical treatment of epilepsy, with renewed interest in the classic procedures and development of new ones such as selective amygdalohippocampectomy. Surgery is being increasingly used in the treatment of medically intractable seizures. Exact presurgical evaluation, with definition of the focus, is of the utmost importance and good results are largely dependent on case selection for surgical therapy. The various therapeutic options such as temporal lobectomy, selective amygdalohippocampectomy, extratemporal cortical resections, hemispherectomy and corpus callosotomy are described and the risks and benefits of surgery discussed. Selective amygdalohippocampectomy, anterior temporal lobectomy and hemispherectomy yield very rewarding results as regards seizure control, while corpus callosotomies frequently reduce the number and severity of generalized seizures.
我们正在见证癫痫外科治疗的复兴,人们对经典手术方法重新产生兴趣,并开发了如选择性杏仁核海马切除术等新手术。手术越来越多地用于治疗药物难治性癫痫发作。精确的术前评估,明确癫痫病灶,至关重要,而良好的治疗效果很大程度上取决于手术治疗的病例选择。文中描述了颞叶切除术、选择性杏仁核海马切除术、颞叶外皮质切除术、大脑半球切除术和胼胝体切开术等各种治疗选择,并讨论了手术的风险和益处。选择性杏仁核海马切除术、前颞叶切除术和大脑半球切除术在控制癫痫发作方面取得了非常可观的效果,而胼胝体切开术常常能减少全身性癫痫发作的次数和严重程度。