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석회화 종괴 병변을 가진 난치성 측두엽 간질의 수술적 치료

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Affiliated Author(s)
김엘손은익이장철김동원임만빈김인홍배정인
Alternative Author(s)
Kim, ElSon, Eun IkLee, Jang ChullKim, Dong WonYim, Man BinKim, In HongBae, Jung In
Journal Title
대한신경외과학회지
ISSN
1225-8245
Issued Date
1995
Abstract
We present 10 patients who underwent temporal lobe surgery for seizure control in our instituition between December, 1992 and October, 1994. Preoperative neuroimaging studies of all 10 patients showed calcified mass lesions within the temporal lobe. Among them, 5 cases had mesial temporal calcified mass dose to the hippocampus, 3 diffuse mass in the temporal lobe or multilobes and 2 in the temporal tip. All patients presented with complex partial seizure and seven had secondary generalization from their seizures. The duration of epileptic seizure varied between 4 and 23 years(mean 13 year). The patients were refractory to therapeutic levels of antironvulsant medication. Presurgical evaluations of epilepsy included a detailed clinical history, multiple scalp/shenoidal EEG, prolonged Video-EEG monitoring, neuroimaging, neuropsychological test, WADA test and invasive study with subdural strip electrodes. Anterior temporal lobectomy with lesionectomy were performed in six cases and anterior temporal lobectomy in four cases using intraoperative electrocorticography(ECoG) and/or functional mapping under local or general anesthesia. The extent of resection of amygdala and hippocampus were determined according to electrocorticographic findings. The verified histopathology of the calcified lesions revealed 1 oligodendroglioma, 1 mixed glioma, 1 arteriovenous malformation, 1 paragonimiasis, 2 neurocysticercosis, 1 other parasitic granuloma and 3 calcified fibrous nodule. In four patients, severe hippocampal sclerosis with neuronal cell loss and gliosis wert observed. After a mean postoperative follow-up of 9 months, 9 patients showed a seizure-free outcome and one patient a significant reduction in seizure activity. We condude from our studies that temporal lobe surgery for patients refractory to therapeutic levels of long-term anticonvulsan t medication can result in excellent postoperative seizure-free outcome in the majority of the patients, and that brain tumors, vascular malformations, and parasitic infections may be considered as etiologic factors of calcified mass lesions in the temporal lobe of such patient.
Alternative Title
Surgery of Intractable Epilepsy with Calcified Mass Lesions in the Temporal Lobe
Department
Dept. of Neurosurgery (신경외과학)
Dept. of Anesthesiology & Pain Medicine (마취통증의학)
Publisher
School of Medicine
Citation
김일만 et al. (1995). 석회화 종괴 병변을 가진 난치성 측두엽 간질의 수술적 치료. 대한신경외과학회지, 24(11), 1345–1351.
Type
Article
ISSN
1225-8245
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/38997
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Anesthesiology & Pain Medicine (마취통증의학)
1. School of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학)
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