Department of Neurosurgery, Tokyo Women's Medical University, Shinjyuku, Japan.
Department of Neurosurgery, TMG Asaka Medical Center, Asaka, Japan.
Epilepsia Open. 2023 Dec;8(4):1602-1607. doi: 10.1002/epi4.12826. Epub 2023 Sep 25.
A 62-year-old female experienced an extensive cerebral contusion in the left frontotemporal lobe due to an acute subdural hematoma at the age of 44 years. Six months after the injury, the patient developed epileptic seizures. The seizures were generalized with right cervical rotation and fencing posture. Despite prescriptions for four antiepileptic drugs, partial seizures occurred several times a month and focal to bilateral tonic-clonic seizures once every 2 months. Video-electroencephalography showed epileptic discharges in the left frontal lobe. The patient was subsequently referred to our department for palliative surgery. The patient underwent a left Forel-H-tomy. The prescription of antiepileptic drugs was not changed, and the patient was seizure free for 1 year. Forel-H-tomy, a surgical procedure for intractable epilepsy, was pioneered by Dennosuke Jinnai. Despite its previously reported remarkable efficacy, Forel-H-tomy has not been performed for several decades. Nevertheless, it remains a potential alternative treatment option for drug-resistant epilepsy.
一位 62 岁的女性在 44 岁时因急性硬膜下血肿导致左额颞叶广泛脑挫裂伤。受伤后 6 个月，患者出现癫痫发作。发作呈全身性，伴有右侧颈部旋转和击剑姿势。尽管开了四种抗癫痫药物，但每月仍会出现部分性发作，每 2 个月会出现一次局灶性双侧强直阵挛性发作。视频脑电图显示左额叶有癫痫放电。随后，患者被转介到我们科室进行姑息性手术。患者接受了左额下回切除术。抗癫痫药物的处方没有改变，患者术后 1 年无癫痫发作。额下回切除术是一种治疗难治性癫痫的手术方法，由神谷稔首创。尽管该手术此前有报道称疗效显著，但几十年来一直未被采用。然而，它仍然是耐药性癫痫的一种潜在替代治疗选择。
