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颞叶切除手术治疗药物难治性癫痫:并发症及副作用综述

Temporal lobe resective surgery for medically intractable epilepsy: a review of complications and side effects.

作者信息

Georgiadis Iordanis, Kapsalaki Effie Z, Fountas Kostas N

机构信息

Departments of Neurosurgery, University Hospital of Larisa, Faculty of Medicine, University of Thessaly, Biopolis, Larissa 41110, Greece.

出版信息

Epilepsy Res Treat. 2013;2013:752195. doi: 10.1155/2013/752195. Epub 2013 Oct 31.

Abstract

Object. It is widely accepted that temporal resective surgery represents an efficacious treatment option for patients with epilepsy of temporal origin. The meticulous knowledge of the potential complications, associated with temporal resective procedures, is of paramount importance. In our current study, we attempt to review the pertinent literature for summating the complications of temporal resective procedures for epilepsy. Method. A PubMed search was performed with the following terms: "behavioral," "cognitive," "complication," "deficit," "disorder," "epilepsy," "hemianopia," "hemianopsia," "hemorrhage," "lobectomy," "medial," "memory," "mesial," "neurobehavioral," "neurocognitive," "neuropsychological," "psychological," "psychiatric," "quadranopia," "quadranopsia," "resective," "side effect," "surgery," "temporal," "temporal lobe," and "visual field." Results. There were six pediatric, three mixed-population, and eleven adult surgical series examining the incidence rates of procedure-related complications. The reported mortality rates varied between 0% and 3.5%, although the vast majority of the published series reported no mortality. The cumulative morbidity rates ranged between 3.2% and 88%. Conclusions. Temporal resective surgery for epilepsy is a safe treatment modality. The reported morbidity rates demonstrate a wide variation. Accurate detection and frank reporting of any surgical, neurological, cognitive, and/or psychological complications are of paramount importance for maximizing the safety and improving the patients' overall outcome.

摘要

目的。广泛认为颞叶切除手术是颞叶起源癫痫患者的一种有效治疗选择。详细了解与颞叶切除手术相关的潜在并发症至关重要。在我们当前的研究中,我们试图回顾相关文献以总结颞叶切除治疗癫痫手术的并发症。方法。在PubMed上进行搜索,搜索词如下:“行为的”“认知的”“并发症”“缺陷”“障碍”“癫痫”“偏盲”“象限盲”“出血”“叶切除术”“内侧的”“记忆”“内侧的”“神经行为的”“神经认知的”“神经心理学的”“心理的”“精神的”“象限盲”“象限视野缺损”“切除性的”“副作用”“手术”“颞部的”“颞叶”及“视野”。结果。有6个儿科、3个混合人群和11个成人手术系列研究了手术相关并发症的发生率。报道的死亡率在0%至3.5%之间,尽管绝大多数已发表的系列报道无死亡病例。累积发病率在3.2%至88%之间。结论。癫痫的颞叶切除手术是一种安全的治疗方式。报道的发病率显示出很大差异。准确检测并坦率报告任何手术、神经、认知和/或心理并发症对于最大限度提高安全性和改善患者总体预后至关重要。

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