Turk J Med Sci. 2014;44(5):866-70. doi: 10.3906/sag-1307-30.
BACKGROUND/AIM: In the treatment of epilepsy, encouraging results have been achieved with surgical treatment, especially for temporal lobe epilepsy (TLE). Drug resistance must be diagnosed as early as possible, because the ensuing seizures can be eliminated surgically via temporal lobe surgery in a high percentage (70%-90%) of patients. In this study we share our experience, in a single institution, of surgical treatment of intractable TLE.
Between March 2006 and November 2010 we performed 127 corticoamygdalohippocampectomy (CAH) procedures. All CAH surgical procedures were done as described by Niemeyer's technique. Resection lengths were 4-4.5 cm from the temporal pole.
At the end of 24 months, 79.7% (n = 94) patients were still on antiepileptic medications, with 55 of them on a decreased number or dose of drugs, and 20.3 (n = 24) patients were antiepileptic drug-free. Postoperative Engel's classes were 1, 2, and 3 in 87.2%, 5.08%, and 7.6%, respectively. There was no mortality in follow-up, and dysphasia in 1 patient (0.84%) was the only morbidity.
In our series we found that the outcome of surgery is associated with careful patient selection, which requires a detailed investigation of the patients. Our final conclusion is that outcome scores are independent of age, pathology, or sex but are dependent on correct patient selection.
背景/目的：在癫痫的治疗中，手术治疗取得了令人鼓舞的效果，尤其是对于颞叶癫痫（TLE）。必须尽早诊断出耐药性，因为在 70%-90%的患者中，可以通过颞叶手术消除随之而来的癫痫发作。在这项研究中，我们分享了我们在单一机构中对难治性 TLE 进行手术治疗的经验。
2006 年 3 月至 2010 年 11 月，我们进行了 127 例皮质杏仁核海马切除术（CAH）。所有 CAH 手术均按照 Niemeyer 技术进行。切除长度从颞极开始为 4-4.5 厘米。
在 24 个月结束时，79.7%（n = 94）的患者仍在服用抗癫痫药物，其中 55 例减少了药物的数量或剂量，20.3%（n = 24）的患者无需服用抗癫痫药物。术后 Engel 分级分别为 1、2 和 3，分别为 87.2%、5.08%和 7.6%。随访中无死亡病例，1 例（0.84%）出现语言障碍。
在我们的系列研究中，我们发现手术的结果与患者的精心选择有关，这需要对患者进行详细的调查。我们的最终结论是，手术结果与年龄、病理或性别无关，但与正确的患者选择有关。
