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首页> 外文期刊>Seizure: the journal of the British Epilepsy Association >Outcome after cortico-amygdalo-hippocampectomy in patients with severe bilateral mesial temporal sclerosis submitted to invasive recording.
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Outcome after cortico-amygdalo-hippocampectomy in patients with severe bilateral mesial temporal sclerosis submitted to invasive recording.

机译：严重双侧颞叶内侧硬化的患者行皮质-杏仁核-海马切除术后的结果需进行有创记录。

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INTRODUCTION: Although some degree of bilateral hippocampal involvement might be frequent in patients with temporal lobe epilepsy, severe bilateral mesial temporal sclerosis (MTS) is very rare. We present our experience while treating patients with severe bilateral MTS submitted to invasive recordings. METHODS: Nine adult patients were studied. All patients had simple and complex partial seizures. All patients had bilateral independent interictal temporal lobe spiking and non-lateralizing video-EEG findings. MRI showed severe bilateral MTS and no other brain lesion. All patients had severe verbal and non-verbal memory deficits. All patients were submitted to invasive recordings after bilateral subdural grids implantation. Cortico-amygdalo-hippocampectomy (CAH) was performed in all patients on the side suggested by invasive recording. Follow-up time ranged from 5 to 10 years. RESULTS: Invasive video-EEG showed exclusively unilateral seizure onset in seven patients; in two patients, seizures originating from both temporal lobes were found (80% of them originated from one side). Five patients were submitted to left and four to right CAH. Seven patients were rendered seizure-free after surgery (Engel I); the other two were rated as Engel II. There was no additional memory decline. There was no surgical morbidity or mortality. Pathological examination showed MTS in all patients. DISCUSSION: Good surgical outcome (77% seizure-free patients) could be obtained even in this apparently unsuitable group of patients. All patients benefit from the procedure. We did not see any cognitive decline in our patients with severe bilateral MTS. Patients with severe bilateral MTS would need invasive recordings despite any findings during surface video-EEG.
机译：简介：尽管颞叶癫痫患者可能会经常发生某种程度的双侧海马受累，但严重的双侧中颞叶硬化症（MTS）很少见。我们介绍我们的经验，同时治疗严重的双侧MTS并接受有创录音的患者。方法：对9名成人患者进行了研究。所有患者均有简单和复杂的部分性发作。所有患者均具有双侧独立的颞叶颞尖峰和非侧斜视频脑电图结果。 MRI显示双侧MTS严重，无其他脑部病变。所有患者都有严重的口头和非语言记忆障碍。在双侧硬脑膜下植入网格后，所有患者均接受了侵入性记录。对有创记录提示的所有患者，均行皮质-杏仁核-海马切除术（CAH）。随访时间为5至10年。结果：侵入性视频脑电图显示仅7例患者单侧发作。在两名患者中，发现了源自两个颞叶的癫痫发作（其中80％来自一侧）。五例患者接受左CAH，四例接受右CAH。七名患者术后无癫痫发作（Engel I）;另外两个被评为恩格尔二世。没有其他内存减少。没有手术发病率或死亡率。病理检查显示所有患者均患有MTS。讨论：即使在这个显然不合适的患者组中，也可以获得良好的手术结果（无癫痫发作的患者为77％）。所有患者都将从该程序中受益。在重度双侧MTS患者中，我们没有发现任何认知下降。重度双侧MTS患者尽管在表面视频脑电图过程中发现了任何发现，仍需要有创记录。

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