海马硬化所致药物抵抗性癫痫外科干预的研究进展

Research Progress on Surgical Intervention for Drug-Resistant Epilepsy Caused by Hippocampal SclerosisYOU Xu1, SONG Zheng- Fen1, WANG Hai-Jin1, WU Xiao-Qin2, ZHANG Yun-Qiao2,YUAN Yong2

摘要:

海马硬化是药物抵抗性颞叶癫痫的主要病理基础。近年来，外科手术在精准化、微创化和个体化方向取得显著突破。本文系统综述了前颞叶切除术选择性杏仁核-海马切除术的技术革新，激光间质热疗、射频热凝等微创技术的临床进展，以及神经调控技术的探索，并结合最新文献分析预后影响因素和未来发展方向。

Abstract:

Hippocampal sclerosis is recognized as the primary pathological substrate underlying drug-resistant temporal lobe epilepsy, a condition that poses significant challenges in clinical management. In recent years, surgical interventions have witnessed remarkable advancements, particularly in the domains of precision, minimally invasive techniques, and personalized treatment approaches. This article systematically reviews the latest technical innovations in anterior temporal lobectomy and selective amygdalohippocampectomy, highlighting their evolving role in optimizing seizure control while minimizing cognitive and functional deficits. Additionally, it explores the clinical progress of minimally invasive modalities, including laser interstitial thermal therapy and radiofrequency thermocoagulation, which offer promising alternatives for patients unsuitable for traditional resective surgery. The review also delves into the emerging field of neuromodulation therapies, such as responsive neurostimulation and deep brain stimulation, which are reshaping the therapeutic landscape for drug-resistant temporal lobe epilepsy. By integrating insights from the most recent literature, this article further analyzes key prognostic factors influencing surgical outcomes and discusses future directions, including the potential of artificial intelligence-guided surgical planning and the development of novel biomarkers for patient selection.