Elger C E, Schramm J
Klinik für Epileptologie, Neurochirurgische Klinik, Universität Bonn.
Radiologe. 1993 Apr;33(4):165-71.
Twenty percent of the approximately 800,000 epileptic patients in Germany cannot be treated adequately by pharmacotherapy alone. According to conservative estimates, epilepsy surgery could be of fundamental therapeutic benefit to at least 10-25% of these patients. A complex presurgical diagnostic program is the basis for any epilepsy surgery. Numerous methods are used to create a hypothesis about the location and size of the epileptogenic area. In addition, before surgery is performed, it must be established that no additional serious neurological or neuropsychological deficits will result from the planned resection. For this purpose, electrostimulation of the cortex and temporary anaesthesia of brain areas by amobarbital tests are performed. In intractable epilepsy originating in the temporal lobe about 60% of patients become seizure free after surgery. Another 15-20% benefit from surgery by a significant improvement in their seizure situation. Resections of the dominant temporal lobe result in further impairment of memory functions in about 20-30% of patients.
在德国约80万癫痫患者中，20%无法仅通过药物治疗得到充分治疗。据保守估计，癫痫手术可能对至少10% - 25%的此类患者具有根本的治疗益处。复杂的术前诊断程序是任何癫痫手术的基础。众多方法被用于对致痫区域的位置和大小形成假设。此外，在进行手术前，必须确定计划中的切除不会导致额外的严重神经或神经心理缺陷。为此，要进行皮质电刺激以及通过异戊巴比妥试验对脑区进行临时麻醉。在起源于颞叶的难治性癫痫中，约60%的患者术后不再发作。另外15% - 20%的患者因癫痫发作情况显著改善而从手术中获益。切除优势颞叶会导致约20% - 30%的患者记忆功能进一步受损。
