CAJ | 학술논문

目的：评价双侧海马杏仁复合体毁损术治疗双颞叶内侧型癫痫的疗效与安全性。方法：对实施双侧海马杏仁复合体小体积毁损术的12例双颞叶内侧型癫痫患者进行回顾性分析，通过 Engel 分级与Liverpool 癫痫严重程度量表2．0（LESS 2．0）评价癫痫控制效果，并通过韦氏成人智力量表及记忆量表判定手术对脑功能的影响。结果：随访时间12～62个月，5例患者发作消失（ Engel Ⅰ级），另7例仍有癫痫发作者，LESS 2．0评分明显下降（P ＜0．05）；术后暂时智力与记忆力有轻度下降，但无统计学意义（P ＞0．05），而在术后6个月则均明显提高（P ＜0．05）。结论：双侧海马杏仁复合体毁损术可终止或减少双颞叶内侧型癫痫的发作，在小体积毁损的前提下，神经心理学功能并无严重影响，甚至随着癫痫发作的控制而有所提高。
목적：평개쌍측해마행인복합체훼손술치료쌍섭협내측형전간적료효여안전성。방법：대실시쌍측해마행인복합체소체적훼손술적12례쌍섭협내측형전간환자진행회고성분석，통과 Engel 분급여Liverpool 전간엄중정도량표2．0（LESS 2．0）평개전간공제효과，병통과위씨성인지역량표급기억량표판정수술대뇌공능적영향。결과：수방시간12～62개월，5례환자발작소실（ Engel Ⅰ급），령7례잉유전간발작자，LESS 2．0평분명현하강（P ＜0．05）；술후잠시지력여기억력유경도하강，단무통계학의의（P ＞0．05），이재술후6개월칙균명현제고（P ＜0．05）。결론：쌍측해마행인복합체훼손술가종지혹감소쌍섭협내측형전간적발작，재소체적훼손적전제하，신경심이학공능병무엄중영향，심지수착전간발작적공제이유소제고。
Objective To retrospectively analyze the effect and safety of bilateral stereotactic radiofrequency amygdalohippocampectomy (SAHE) for treatment of bilateral medial temporal lobe epilepsy (BMTLE). Methods Twelve BMTLE patients were treated with bilateral SAHE under limited coagulations. Clinical parameters were evaluated with the programs of Engel′s classification, Liverpool Seizure Severity Scale (LSSS) 2.0, Wechsler Adult Intelligence Scale-Revised (WAIS-R) and Wechsler Memory Scale-Revised (WMS-R), respectively. Results Five patients (42%) were assessed as EngelⅠwith 12 ~ 62-month follow-up. Seizure severity scores were declined sharply compared with the baseline of the patients with out seizure free. Function of memory and intelligence was transiently declined without statistical significance immediately after operation (P >0.05), but was significantly increasedat 6 months after operation (P < 0.05). Conclusion Bilateral SAHE could terminate seizures or reduce seizure severity in patients with BMTLE. Under the circumstance of limited coagulations, neuropsychological function was improved along with seizure control.