CAJ | 학술논문

目的探讨慢性海马电刺激治疗颞叶癫痫的疗效和安全性. 方法选择首都医科大学宣武医院自2011年2月至2012年5月收治的,术前评估认为不适宜行前颞叶切除术的2例颞叶癫痫患者,立体定向下向患侧海马头部埋置刺激电极,术后进行慢性电刺激,观察控制癫痫发作的效果及不良反应. 结果 2例患者刺激器埋置术后及慢性电刺激开启后均未见明显不良反应.分别随访22个月和10个月,病例1发作次数由原来的(3～4)次/月减少至2～3个月1次;且发作程度明显减轻,发作时间较前缩短.病例2由原来的(6～10)余次/月减少至(3～6)次/月;发作时间较前缩短,很少继发全面强直阵挛发作. 结论对于部分不适合行前颞叶切除手术的难治性颞叶癫痫患者,慢性海马电刺激可能有助于控制癫痫发作.
목적 탐토만성해마전자격치료섭협전간적료효화안전성. 방법 선택수도의과대학선무의원자2011년2월지2012년5월수치적,술전평고인위불괄의행전섭협절제술적2례섭협전간환자,입체정향하향환측해마두부매치자격전겁,술후진행만성전자격,관찰공제전간발작적효과급불량반응. 결과 2례환자자격기매치술후급만성전자격개계후균미견명현불량반응.분별수방22개월화10개월,병례1발작차수유원래적(3～4)차/월감소지2～3개월1차;차발작정도명현감경,발작시간교전축단.병례2유원래적(6～10)여차/월감소지(3～6)차/월;발작시간교전축단,흔소계발전면강직진련발작. 결론 대우부분불괄합행전섭협절제수술적난치성섭협전간환자,만성해마전자격가능유조우공제전간발작.
Objective To evaluate the effectiveness and safety of chronic hippocampus electrical stimulation in treatment of patients with temporal lobe epilepsy.Methods The patients with temporal lobe epilepsy who were not suitable for anterior temporal lobectomy were selected.The patients had a 6-month-seizure count as baseline frequency.Medtronic electrodes were implanted directed into the amygdalohippocampal foci.After electroencephalography recording and interval stimulation for one week,implantable pulse generators were implanted and began to stimulate chronically.Seizure frequency was counted in the follow up.The efficacy and side-effect were also detected.Results Two patients were selected according to the criteria.There was no obvious side effect except for transient dizziness in one patient.One patient had a seizure reduction of＞80％ in a 22-month follow-up (decreasing from 3-4 times/month to 2-3 times/month); the seizure time was shorten and severity was alleviated than before treatment The other patient had a seizure reduction of＞50％ in a 10-month follow-up (decreasing from 6-10 times/month to 3-6 times/month); the seizure time was shorten than before treatment with few secondary generalized tonic-clonic seizures.Conclusion Chronic hippocampus electrical stimulation is a safe treatment for some patients with temporal lobe epilepsy who are not suitable for anterior temporal lobectomy; it may be helpful in controlling the seizures.