CAJ | 학술논문

目的探讨裁剪式前颞叶内侧切除术治疗颞叶内侧型癫痫的手术方法和治疗效果.方法 21例顽固性颞叶癫痫患者,采用脑功能制图及神经导航等辅助,行裁剪式前颞叶内侧切除术治疗,切除前颞叶、杏仁核及海马.采用分级量表针对癫痫发作控制效果进行评价.结果术后随访6 ～ 29个月,21例患者神经功能均改善,无严重手术并发症.其中Engel Ⅰ级16例(76％)；EngelⅡ级3例(14％)；EngelⅢ级2例(10％).结论裁剪式前颞叶内侧切除术是治疗颞叶癫痫的有效方法.脑功能制图及神经导航辅助下手术切除杏仁核及海马彻底,避免了语言区和视放射的损伤.
목적 탐토재전식전섭협내측절제술치료섭협내측형전간적수술방법화치료효과.방법 21례완고성섭협전간환자,채용뇌공능제도급신경도항등보조,행재전식전섭협내측절제술치료,절제전섭협、행인핵급해마.채용분급량표침대전간발작공제효과진행평개.결과 술후수방6 ～ 29개월,21례환자신경공능균개선,무엄중수술병발증.기중Engel Ⅰ급16례(76％)；EngelⅡ급3례(14％)；EngelⅢ급2례(10％).결론 재전식전섭협내측절제술시치료섭협전간적유효방법.뇌공능제도급신경도항보조하수술절제행인핵급해마철저,피면료어언구화시방사적손상.
Objective To explore the surgical skills,effects and complications of Tailored Temporal lobectomy via the anterolateral Approach for the treatment of mesial temporal lobe epilepsy (MTLE).Methods The Temporal lobectomy via the anterolateral Approach was performed under the guidance of functional brain mapping and neuronavigation system in 21 patients with intractable MTLE.All the patients were followed up from 6 to 29 months after surgeries.Results In 21 patients,16 patients (76％),3 patients(14％) and 2 patients(10％) belonged in Engel grade Ⅰ (seizure-free),grade Ⅱ (rare seizures) and grade Ⅲ (worthwhile improvement),respectively.Neuro-functions were improved after the surgeries in 16 patients.No severe complications occurred in all the patients.Conclusions The Temporal lobectomy via the anterolateral Approach under the guidance of functional brain mapping and neuronavigation system is an effective method of treating intractable MTLE because the volume of medial hippocampus and amygdala removal is extremely variable.It also provides a protective way of the optic radiation and language area.