| 摘要 |
Structural lesions are found in about 30% of patients who undergo epilepsy
surgery for intractable temporal lobe epilepsy. After detailed presurgical evaluations, the
concordance of semeiology, focal structural lesions, ictal and interictal epileptiform
discharges and neuropsychological dysfunction may offer favorable seizure control outcome
postoperatively. The temporal lobe structural lesions are classified by magnetic resonance
imaging-defined location into mesial temporal and lateral temporal (extrahippocampal)
groups. In the lateral temporal group, subdural grid and depth electrode implantation is
mandatory to localize the epileptic cortex and the possible secondary focus in the mesial
temporal structures. Different surgical strategies, such as lesionectomy alone, lesionectomy
with removal of adjacent epileptic cortex, lesionectomy with removal of mesiotemporal
structures, have variable seizure control outcomes. The underlying pathology and the
completeness of the lesion resection also affect the outcome. |
