Chung S S, Lee K H, Chang J W, Park Y G
Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea.
Stereotact Funct Neurosurg. 1998;70(2-4):81-8. doi: 10.1159/000029602.
Cortical resective surgery (including amygdalohippocampectomy) and corpus callosotomy are the most widely accepted modes of surgical treatment for intractable epilepsy. Between July 1989 and May 1996, 146 surgeries for epilepsy were done at Severance Hospital, Yonsei University. Resective surgery was performed in 126 patients and corpus callosotomy in 20 patients. Of the 126 patients who underwent resective surgery, surgery for the removal of the epileptic lesion (lesionectomy) was performed in 21 patients (16.7%) while 105 patients (83.3%) underwent surgery without a structural lesion. Current surgical therapy for intractable epilepsy requires the precise localization of a resectable zone of epileptogenesis. Unfortunately, finding a localized focus in an extratemporal region is far more difficult than in the temporal lobe. Surgeries for extratemporal lobe epilepsy without lesions have been less successful than surgeries for temporal lobe epilepsy. Although surgery for intractable epilepsy has been increasingly successful, we still need to refine our techniques to further improve the success rate and to reduce complications of surgery such as language and memory impairment.
皮质切除术（包括杏仁核海马切除术）和胼胝体切开术是治疗难治性癫痫最广泛接受的手术方式。1989年7月至1996年5月，延世大学Severance医院进行了146例癫痫手术。126例患者接受了切除手术，20例患者接受了胼胝体切开术。在接受切除手术的126例患者中，21例（16.7%）进行了切除癫痫病灶的手术（病灶切除术），而105例（83.3%）患者在没有结构性病灶的情况下接受了手术。目前难治性癫痫的手术治疗需要精确确定可切除的癫痫发生区域。不幸的是，在颞叶外区域找到局限性病灶比在颞叶困难得多。无病灶的颞叶外癫痫手术不如颞叶癫痫手术成功。尽管难治性癫痫的手术越来越成功，但我们仍需改进技术，以进一步提高成功率并减少手术并发症，如语言和记忆障碍。
