Cutfield R G, Wrightson P
North Shore Hospital.
N Z Med J. 1987 Mar 25;100(820):163-6.
Twenty-six patients were subjected to temporal lobectomy for complex partial seizures resistant to anticonvulsant control. The criteria for selection were simple. There should be EEG evidence of epileptiform activity arising predominantly in one temporal lobe. It was desirable that psychometric tests should confirm the localisation by showing defects of function in this lobe, and necessary that they should demonstrate normal function in the other. There should be no radiological evidence of a gross structural lesion. Twenty-four patients have been followed for 5 to 17 years, two being lost at 3 and 4 years. After operation, 50% were completely free from seizures, and in a further 38% seizures were reduced in frequency by at least 75%. There was no mortality, and the only morbidity was a minor quadrantic hemianopia, usually unnoticed by the patient. A significant improvement in mental state was noted in many patients. It is concluded that to use simple criteria for selection of patients for temporal lobectomy gives worthwhile results. There are many patients in the community who could be selected for surgery on these criteria with a high probability that their condition would be improved.
26例患有复杂部分性癫痫且抗惊厥药物控制无效的患者接受了颞叶切除术。选择标准很简单。脑电图应有证据表明癫痫样活动主要起源于一侧颞叶。理想的情况是，心理测试应通过显示该叶功能缺陷来证实定位，且必须证明另一侧功能正常。不应有明显结构病变的放射学证据。24例患者已随访5至17年，2例分别在3年和4年时失访。术后，50%的患者癫痫完全缓解，另有38%的患者癫痫发作频率至少降低了75%。无死亡病例，唯一的并发症是轻度象限性偏盲，患者通常未注意到。许多患者的精神状态有显著改善。结论是，采用简单的标准选择颞叶切除术患者可获得有价值的结果。社区中有许多患者可根据这些标准被选作手术对象，其病情很有可能得到改善。
