颞叶脑膨出所致难治性癫痫的临床分析

doi:10.3969/j.issn.1006-7795.2026.03.024

首都医科大学学报 ›› 2026, Vol. 47 ›› Issue (3): 603-611.doi: 10.3969/j.issn.1006-7795.2026.03.024

颞叶脑膨出所致难治性癫痫的临床分析

高武霖¹,范鸿飞² , 陈维达¹,崔韬^3,4*＃ , 王华^1*＃

1.山东中医药大学附属医院老年医学中心，济南 250011； 2. 山东中医药大学眼科与视光医学院 2022级，济南 250014；3. 首都医科大学附属北京天坛医院神经病学中心，北京 100070； 4. 国家神经系统疾病临床医学研究中心，北京 100070

收稿日期:2026-03-11 修回日期:2026-04-14 出版日期:2026-06-21 发布日期:2026-06-26
通讯作者: 崔韬,王华 E-mail:cuitaocn@aliyun.com; wang1386409@163.com
基金资助:
国家重点研发计划项目 (2019YFC1710400),山东省医药卫生科技项目（2023BJ000051）。

Clinical analysis of refractory epilepsy caused by temporal encephalocele

Gao Wulin¹, Fan Hongfei², Chen Weida¹, Cui Tao^3,4*＃, Wang Hua^1*＃

1. Geriatric Medicine Center, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250011, China; 2. Grade 2022, Ophthalmology & Optometry Medical School, Shandong University of Traditional Chinese Medicine, Jinan 250014, China; 3. Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China; 4. China National Clinical Research Center for Neurological Diseases, Beijing 100070, China

Received:2026-03-11 Revised:2026-04-14 Online:2026-06-21 Published:2026-06-26
Supported by:
This study was supported by National Key Research and Development Program of China (2019YFC1710400), Shandong Province Medical and Health Science and Technology Project (2023BJ000051).

摘要/Abstract

摘要： 目的本研究通过分析颞叶脑膨出患者的临床数据，以明确该疾病的诊断线索与治疗策略。方法本研究分析了 2020年1月至 2025年8月期间在首都医科大学附属北京天坛医院就诊的颞叶癫痫患者。在158例接受颞叶癫痫手术的患者中，筛选出7例颞叶脑膨出患者作为研究队列，对其临床特征、脑电图（electroencephalogram, EEG）、影像学检查、神经心理评估及长期预后数据进行分析。结果本研究中颞叶脑膨出的癫痫患者为4例男性和3例女性，平均年龄42.4岁（年龄范围 28~72岁）。7例患者均表现有局灶性意识障碍发作，5例患者具有局灶进展到双侧强直阵挛发作。初次磁共振成像（magnetic resonance imaging, MRI）仅检出2例患者的颞叶脑膨出，其余5例均漏诊。7例患者中6例接受了标准前颞叶切除术加脑膜修补术，1例服药治疗。经过平均28个月（14~55个月）的随访，5例患者癫痫预后达到Engel Ⅰ级，1例达到Engel Ⅱa级，1例Engel Ⅳ级。病理检查结果显示：5例患者存在胶质增生，1例为神经节细胞瘤。认知功能评测提示左侧病变者记忆功能受累多见。结论对于难治性颞叶癫痫患者，需仔细审阅其 MRI 等影像，排查是否存在颞叶脑膨出的可能。当颞叶癫痫与脑膨出相关时，采用手术治疗方案，可改善长期临床预后。

关键词: 颞叶脑膨出, 颞叶癫痫, 药物难治性癫痫, 磁共振成像, 癫痫手术, 预后

Abstract: Objective This study aims to clarify the diagnostic clues and treatment strategies for temporal lobe encephalocele by analyzing the clinical data of patients with temporal lobe encephalocele.Methods We retrospectively analyzed patients with temporal lobe epilepsy treated at Beijing Tiantan Hospital, Capital Medical University between January 2020 and August 2025. Among 158 patients who underwent temporal lobe epilepsy surgery, 7 patients with temporal encephalocele were enrolled as the study cohort. Their clinical characteristics, electroencephalography (EEG), neuroimaging, neuropsychological assessments, and longterm prognosis were analyzed. Results The 7 patients included 4 males and 3 females, with a mean age of 42.4 years (range 28-72 years). All 7 patients presented with focal impaired awareness seizures, and 5 had focal to bilateral tonicclonic seizures. Initial magnetic resonance imaging (MRI) detected temporal encephalocele in only 2 patients; the other 5 were missed. Of the 7 patients, 6 underwent standard anterior temporal lobectomy with meningeal repair, and 1 received medical treatment only. After a mean followup of 28 months (range 14-55 months), 5 patients achieved Engel class I, 1 achieved Engel class Ⅱa, and 1 had Engel class Ⅳ. Pathological findings showed gliosis in 5 patients and gangliocytoma in 1 patient. Cognitive evaluation revealed that memory impairment was more common in patients with leftsided lesions. Conclusion In patients with drugresistant temporal lobe epilepsy, MRI and other neuroimages should be carefully reviewed to rule out temporal encephalocele. Surgical intervention in patients with temporal lobe epilepsy related to encephalocele can improve longterm clinical prognosis.

Key words: temporal encephalocele, temporal lobe epilepsy, drug resistant epilepsy, magnetic resonance imaging, epilepsy surgery, prognosis

中图分类号:

R742.1

高武霖, 范鸿飞, 陈维达, 崔韬, 王华. 颞叶脑膨出所致难治性癫痫的临床分析[J]. 首都医科大学学报, 2026, 47(3): 603-611.

Gao Wulin, Fan Hongfei, Chen Weida, Cui Tao, Wang Hua. Clinical analysis of refractory epilepsy caused by temporal encephalocele[J]. Journal of Capital Medical University, 2026, 47(3): 603-611.

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颞叶脑膨出所致难治性癫痫的临床分析

Clinical analysis of refractory epilepsy caused by temporal encephalocele

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