脑沟脂肪瘤相关颞叶癫痫的手术治疗，无需切除脂肪瘤。

Epilepsy surgery without lipoma removal for temporal lobe epilepsy associated with lipoma in the Sylvian fissure.

机构信息

Department of Neurosurgery, Juntendo University, Tokyo, Japan.

Department of Neurosurgery, National Defense Medical College, Saitama, Japan.

出版信息

Acta Neurochir (Wien). 2023 Jan;165(1):265-269. doi: 10.1007/s00701-022-05330-7. Epub 2022 Aug 8.

DOI:10.1007/s00701-022-05330-7

PMID:35934751

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9840568/

Abstract

Epileptic seizure is the common symptom associated with lipomas in the Sylvian fissure (Sylvian lipomas). Removal of these lipomas carries risks of hemorrhage and brain damage. We report a surgical strategy of not removing the lipoma in a case of intractable temporal lobe epilepsy associated with Sylvian lipoma. We performed anterior temporal lobectomy with preservation of the pia mater of the Sylvian fissure and achieved seizure freedom. Focal cortical dysplasia type 1 of the epileptic neocortex adjacent to the Sylvian lipoma was pathologically diagnosed. We recommend our surgical procedure in similar cases to avoid complications and achieve adequate seizure control.

摘要

癫痫发作是与西尔维安裂（西尔维安脂肪瘤）相关的脂肪瘤的常见症状。切除这些脂肪瘤会有出血和脑损伤的风险。我们报告了一例与西尔维安脂肪瘤相关的难治性颞叶癫痫病例，采用不切除脂肪瘤的手术策略。我们进行了前颞叶切除术，保留了西尔维安裂的软脑膜，并实现了无癫痫发作。癫痫皮质旁的局灶性皮质发育不良 1 型在病理上被诊断为西尔维安脂肪瘤。我们建议在类似病例中采用我们的手术程序，以避免并发症并实现足够的癫痫控制。