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首页> 外文期刊>Journal of Epilepsy and Clinical Neurophysiology >Mesial temporal lobe epilepsy syndrome: an updated overview
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Mesial temporal lobe epilepsy syndrome: an updated overview

机译：颞中叶癫痫综合征：最新概述

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Mesial temporal lobe epilepsy (MTLE) is the most common form of partial epilepsy in young adults and also the most frequent type of epilepsy reported in surgical series worldwide. Mesial temporal lobe sclerosis (MTS) is the major underlying cause of MTLE, and it is present in 60-70% of patients with MTLE who undergo surgery for treatment of medically refractory seizures. Pathogenetic mechanisms underlying this distinct hippocampal pathology remains undetermined. Recent findings suggest a developmental malformation of hippocampus (inherited or acquired) that in association with subsequent injury (e.g. trauma, infection, complex febrile seizures) could develop ongoing seizures, resulting in the full-blown neuropathological features of MTS. Genetic background, age and type of initial precipitating injury, and vulnerability related to programmed cell death pathways are probable mechanisms involved in the development of MTS. Definitions for medical intractability may vary among centers, but usually include failure to achieve seizure control with two or more AEDs with adequate dosage and posology. The decision as to when one should perform surgery in patients with MTLE is a relevant issue that needs more investigation. Recent evidence discussed in this review indicates that longer duration of uncontrolled seizures is associated with an increased risk of unsuccessful surgery.
机译：颞叶颞叶癫痫（MTLE）是年轻人中最常见的部分性癫痫，也是全世界外科手术系列中最常见的癫痫类型。颞叶颞叶硬化症（MTS）是MTLE的主要潜在病因，在接受手术治疗难治性癫痫发作的MTLE患者中，有60-70％存在。这种独特的海马病理学的发病机制仍未确定。最近的发现表明（继发或获得性）海马的发育畸形与随后的损伤（例如外伤，感染，复杂的高热惊厥）可能发展为持续性惊厥，导致MTS的神经病理学特征全面发展。遗传背景，初始沉淀损伤的年龄和类型以及与程序性细胞死亡途径相关的脆弱性可能是MTS发生的机制。在各中心之间，对药物难治性的定义可能有所不同，但通常包括未能用两种或多种具有适当剂量和剂量的AED来实现癫痫发作控制。关于何时应该对MTLE患者进行手术的决定是一个相关的问题，需要更多的研究。这篇综述中讨论的最新证据表明，不受控制的癫痫发作持续时间越长，手术失败的风险就越大。

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