Cahan L D, Engel J
Acta Neurol Scand. 1986 Jun;73(6):551-60. doi: 10.1111/j.1600-0404.1986.tb04599.x.
This year marks the centennial of the first surgical resection for epilepsy performed by Horsley. While epilepsy is generally considered a disease best treated with anticonvulsant medications, surgical therapy is of significant benefit to some patients in whom medical therapy has proved ineffective. Anterior temporal lobectomy has been the single most successful operation commonly performed today. In this paper we review current techniques of preoperative evaluation, the role of scalp and intracranial electrophysiologic monitoring, as well as the contribution of PET and MRI scanning to improving the selection of patients for surgical therapy. The role of focal cortical excisions, hemispherectomy, and corpus callosotomy in the surgical armamentarium is also outlined. A plea is made for establishment of additional regionalized centers for epilepsy surgery in which close collaboration among neurologists, neuropsychologists, neurosurgeons and neurophysiologists can enhance patient care and advance our knowledge of the partial epilepsies and human cerebral function.
今年是霍斯利首次进行癫痫外科切除手术一百周年。虽然癫痫一般被认为是一种最好用抗惊厥药物治疗的疾病，但手术治疗对一些药物治疗无效的患者有显著益处。颞叶前部切除术是目前最常见且最成功的单一手术。在本文中，我们回顾了当前术前评估技术、头皮和颅内电生理监测的作用，以及正电子发射断层扫描（PET）和磁共振成像（MRI）扫描在改善手术治疗患者选择方面的贡献。还概述了局灶性皮质切除术、大脑半球切除术和胼胝体切开术在手术治疗手段中的作用。呼吁建立更多的癫痫手术区域化中心，在这些中心，神经科医生、神经心理学家、神经外科医生和神经生理学家之间密切合作，可以提高患者护理水平，并推进我们对部分性癫痫和人类脑功能的认识。
