Transcortical selective amygdalohippocampectomy in temporal lobe epilepsy
Transcortical selective amygdalohippocampectomy in temporal lobe epilepsy
复制标题
DOI：
10.1017/s031716710000069x
复制
发表时间：
2000-05-01
影响因子：
3
通讯作者：
Olivier, A
中科院分区：
文献类型：
--
作者：
Olivier, A
对颞叶癫痫的电生理学和神经病理学的大量研究表明，大多数病例的癫痫发作起源于内侧颞叶结构。这就是经皮质选择性切除海马体和杏仁核的基本原理，这种方法首先由尼迈耶提出。来自多个中心的系列研究已经证实了选择性杏仁核切除术与传统切除术相比的有效性。蒙特利尔神经学研究所（MNI）所采用的技术，除了计算机图像引导外，还采用了海马结构和杏仁核的严格内膜切除术。在MNI接受选择性杏仁核切除术的患者中，95%的患者实现了癫痫发作的停止，或超过90%的减少，并发症的风险最小。
Numerous studies of the electrophysiology and neuropathology of temporal lobe epilepsy have demonstrated the mesial temporal structures to be the site of seizure origin in the majority of cases. This is the rationale for a transcortical selective approach, first introduced by Niemeyer, for removal of the hippocampus and amygdala. Series from a number of centers have demonstrated the efficacy of selective amygdalohippocampectomy compared to a more traditional resection. The technique described here and used at the Montreal Neurological Institute (MNI) utilizes a strictly endopial resection of the hippocampal formation and amygdala in addition to computer image guidance to perform the procedure. Ninety-five percent of patients at the MNI who underwent selective amygdalohippocampectomy realized a cessation of seizures, or greater than 90% reduction, with minimal risk of complications.