Turner D A, Wyler A R
Epilepsia. 1981 Dec;22(6):623-9. doi: 10.1111/j.1528-1157.1981.tb04136.x.
A Series of 23 patients who underwent unilateral temporal lobectomy for complex partial seizures, with a minimum 1 1/2-year follow-up, is reviewed. The most common pathological finding was mesial temporal sclerosis (52%), and this category represents the best overall outcome in terms of either significant improvement or complete remission of the seizure disorder. Seventy-five percent of the patients with this diagnosis had the operative finding of herniation of mesial temporal structures (specifically the uncus and hippocampus) over the tentorial incisura. This finding was also associated with an excellent result. Computed tomography scans with metrizamide enhancement may reveal preoperatively a unilateral herniated mesial temporal lobe or atrophy of mesial temporal structures, both indicating the diagnosis of mesial temporal sclerosis. Improved identification of patients with subtle structural damage to the mesial temporal lobe in association with EEG foci should increase the success of temporal lobectomy for seizure control.
回顾了一组23例因复杂部分性癫痫接受单侧颞叶切除术的患者，其随访时间最短为1年半。最常见的病理发现是内侧颞叶硬化（52%），就癫痫发作障碍的显著改善或完全缓解而言，这一类别总体预后最佳。该诊断的患者中有75%在手术中发现内侧颞叶结构（特别是钩回和海马）经小脑幕切迹疝出。这一发现也与良好的结果相关。用甲泛葡胺增强的计算机断层扫描术前可能显示单侧内侧颞叶疝出或内侧颞叶结构萎缩，两者均提示内侧颞叶硬化的诊断。提高对内侧颞叶有细微结构损伤并伴有脑电图病灶的患者的识别能力，应能提高颞叶切除术控制癫痫发作的成功率。
