ISSN:0013-9580    

DOI:10.1111/j.1528-1157.1988.tb05105.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Book reviewed in this article:Epilepsy: Diagnosis, Management, Quality of Life. J Kiffin Penry (ed.).Scientific Basis of Clinical Neurology. Michael Swash and Christopher Kennard (eds.).Migraine and Epilepsy. F. Andermann and E. Lugaresi (eds.).Epilepsy and You. Neil Buchanan. Williams&WilkinsDrug Evaluations. 6th Edition. American Medical Association, Department of Drugs. Division of Drugs and Technology.Ethnic Differences in Reactions to Drugs and Xenobiotics. Werner Kalow, H. Werner Goedde, and Dharam P. Agarwal (eds.).Atlas of the Human Brain in Section. Second Edition. Melville P. Roberts, Joseph Hanawuy, and D. Kent Morest.GABAergic Transmission and Anxiety. Advances in Biochemical Psychopharmacology. Giovanni Biggio and E. Costa (eds).Neurologic Clinics. Symposium on Neurosurgery. Leonard I. Kranzler, Richard D. Penn, and George J. Dohrmann (eds.).Neurotoxicology. Kenneth Blum and Luigi Manzo (eds.).Brain Insults in Infants and Children: Pathophysiology and Management. Hector E. James, Nick G. Anas, and Ronald M. Perkin (eds.).Hemispheric Function and Collaboration in the Child. Catherine T. Best (ed.).Hope For a New Neurology. Annals of the New York Academy of Sciences, Volume 457. Fernando Not‐tebohm (ed.).The Cost of Developing a New Drug. Steven N. Wiggins. Pharmaceutical Manufacturers Association, Washington, D.C.Neuromethods–6–Peptides. Alan A. Boulton, Glen B. Baker, and Quentin J. Pittman (

ISSN:0013-9580    

DOI:10.1111/j.1528-1157.1988.tb05106.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Summary:Greater precision in the identification of seizure‐initiating structures and preferential pathways of seizure spread has enabled us to classify complex partial seizures into subtypes. The mediobasal limbic subtype is the most important of these. Because of the paramount importance of amygdala and hippocampus in the majority of patients with temporal lobe epilepsy, we initiated so‐called “selective” amygdalo‐hippocampectomy (AHE) as an alternative to conventional temporal lobectomy for the treatment of medically intractable mediobasal temporal lobe epilepsy. To date, 181 patients have been operated on using this microsurgical approach. Fifty‐two of them had no detectable morphological lesion preoperatively. These were studied either by stereoelectroencephalo‐graphy (SEEG) (n= 42) or using foramen‐ovale (FO) electrodes (n= 10). Mean follow‐up for this group was 47 (6–143) months. Sixty‐two percent are seizure‐free, 10% have only rare seizures, and worthwhile improvement occurred in another 15%. There was no improvement in 13%. Antiepileptic drugs have been discontinued in 21%; the remainder receive one or more drugs. Good postoperative seizure outcome related to the initial seizure‐onset locus being exclusively within the resected structures. “Palliative” AHE is nevertheless an option in those cases in whom the primary focus lies in or close to indispensable neocortex (e.g., speech area) and in whom a secondary pacemaker role of the amygdala‐hippocampus complex has been demonstrated. Further factors influencing outcome include the presence of structural abnormality (especially of hippocampal sclerosis), age at seizure onset, preoperative duration of seizures, and postoperative EEG findings. In patients with a good seizure outcome, learning and memory performance increased, especially for material specific for the nonoper‐ated hemisphere. We conclude that temporal lobe epilepsy with mediobasal limbic seizures is preferably treated surgically by selective amygdalo‐hippocampectomy rather

ISSN:0013-9580    

DOI:10.1111/j.1528-1157.1988.tb05793.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

ISSN:0013-9580    

DOI:10.1111/j.1528-1157.1988.tb05107.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Summary:Physicians who care for patients with epilepsy may function as agents or targets of social control. As agents, they may assist in the identification and control of epileptic drivers, may provide information that enables fair and appropriate job placements for epileptic persons, and give testimony that helps the legal system resolve issues relating to the liability of epileptic persons for harm attributed to seizures or interictal behavioral disturbances. As targets, they may be charged with negligent failure to diagnose, treat, or inform about epilepsy or its associated problems, with failure to exercise due care in protecting persons harmed by their patients, or with failure to preserve confidentiality of medical information. Although legislation and judicial decisions have defined some of the physician's legal duties with reasonable clarity, areas of uncertainty remain, particularly regarding the issue of violating medical confidentiality for the benefit of persons other than the patient.

ISSN:0013-9580    

DOI:10.1111/j.1528-1157.1988.tb05794.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

ISSN:0013-9580    

DOI:10.1111/j.1528-1157.1988.tb05785.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY