Devinsky O, Pacia S
Department of Neurology, New York University School of Medicine, Hospital for Joint Diseases, New York.
Neurol Clin. 1993 Nov;11(4):951-71.
Epilepsy surgery is assuming greater importance in treating patients with partial epilepsy whose seizures are uncontrolled with antiepileptic drugs. Many good candidates for surgical treatment are not presented with the option of surgery. The evaluation for epilepsy surgery is extensive and includes several stages of noninvasive and invasive testing. As more sophisticated noninvasive tests develop, fewer patients require invasive monitoring studies such as depth or subdural electrodes. The principal forms of surgical treatment include focal resection, corpus callosotomy, and hemispherectomy. Temporal lobectomy remains the most common and effective form of epilepsy surgery. Frontiers of epilepsy surgery include resective surgery for intractable infantile spasms and multiple subpial transections for patients whose seizure foci are in sensory, motor, or languages cortex. Additional studies are needed to define the safety and efficacy of these new procedures.
癫痫手术在治疗那些使用抗癫痫药物无法控制癫痫发作的部分性癫痫患者中变得越来越重要。许多适合手术治疗的患者并未得到手术选择。癫痫手术评估范围广泛，包括几个阶段的非侵入性和侵入性检查。随着更先进的非侵入性检查方法的发展，需要进行诸如深部或硬膜下电极等侵入性监测研究的患者越来越少。手术治疗的主要形式包括局灶性切除、胼胝体切开术和大脑半球切除术。颞叶切除术仍然是最常见且有效的癫痫手术形式。癫痫手术的前沿领域包括针对难治性婴儿痉挛的切除性手术以及针对癫痫病灶位于感觉、运动或语言皮层的患者的多处软膜下横切术。需要更多研究来确定这些新手术的安全性和有效性。
