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资源有限条件下颞叶病变所致耐药性癫痫的显微手术:一项横断面研究

Microsurgery for drug resistance epilepsy due to temporal lobe lesions in a resource limited condition: a cross-sectional study.

作者信息

Tran Van Dinh, Nguyen Bac Thanh, Van Dong He, Nguyen Tuan Anh, Nguyen Phuong Xuan, Van Vu Hoe, Chu Hung Thanh

机构信息

Vietnam Military Medical University, Hanoi, Vietnam.

Neurosurgery Center of Vietduc University Hospital, Hanoi, Vietnam.

出版信息

Ann Med Surg (Lond). 2023 Jun 28;85(8):3852-3857. doi: 10.1097/MS9.0000000000001021. eCollection 2023 Aug.

Abstract

UNLABELLED

Epilepsy is a prevalent neurological condition that affects individuals of all ages and genders worldwide. Surgical intervention for drug-resistant epilepsy has been found to improve quality of life, with patient independence being of utmost importance.

METHODS

The study was a retrospective and prospective cross-sectional study of 35 cases of drug-resistant temporal lobe epilepsy. All patients were operated on by the primary author between May 2018 and September 2022. The study evaluated various factors including clinical characteristics, electroencephalogram, magnetic resonance imaging, surgical outcomes, and histopathology.

RESULTS

The success rate of the surgeries (74.3%) is similar to those reported in high-income countries. 51.4% underwent selective amygdalohippocampectomy for cases that localized to the mesial temporal lobe. Lateral/neocortical lesions underwent lesionectomy (48.6%). Our study found a complication rate of 17.1%: meningitis (8.5%), trainset focal paralysis (2.9%), and soft tissue infection (5.7%). There were no mortalities.

CONCLUSIONS

The article showcases an international collaborative effort that demonstrates the possibility of providing highly effective and safe surgical care for temporal lobe epilepsy even in low-resource environments. The authors hope that this model can be replicated in other areas with similar resource limitations.

摘要

未标注

癫痫是一种普遍的神经系统疾病,影响着全球所有年龄和性别的人群。已发现针对耐药性癫痫的手术干预可改善生活质量,患者的独立性至关重要。

方法

该研究是一项对35例耐药性颞叶癫痫患者的回顾性和前瞻性横断面研究。所有患者均由第一作者在2018年5月至2022年9月期间进行手术。该研究评估了各种因素,包括临床特征、脑电图、磁共振成像、手术结果和组织病理学。

结果

手术成功率(74.3%)与高收入国家报告的成功率相似。对于局限于内侧颞叶的病例,51.4%的患者接受了选择性杏仁核海马切除术。外侧/新皮质病变接受了病变切除术(48.6%)。我们的研究发现并发症发生率为17.1%:脑膜炎(8.5%)、偏瘫(2.9%)和软组织感染(5.7%)。无死亡病例。

结论

本文展示了一项国际合作成果,表明即使在资源匮乏的环境中,也有可能为颞叶癫痫提供高效且安全的手术治疗。作者希望这种模式能够在其他资源限制相似的地区得到推广。

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