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内侧颞叶癫痫伴海马硬化是最常见的药物难治性癫痫之一,涉及复杂的神经网络,常需要手术治疗.研究表明儿童期热性惊厥病史是海马硬化发生的危险因素,但相关研究仍不深入准确识别海马硬化,及时指导临床治疗尤为重要.该文概述了海马硬化的分级,从阳离子-氯化物共转运体、谷氨酸及其受体、mRNA表达改变等方面探索其可能的发生机制,并列举出海马硬化的磁共振、MRS波谱、PET的特征性改变,为早期识别海马硬化提供依据,从理论上为进一步预防海马硬化发生、改善内侧颞叶癫痫伴海马硬化患者的生存质量提供思路.“,”The medial temporal lobe epilepsy with hippocampal sclerosis is one of the most common drug resistant epilepsy,which involves complex neural networks and often requires surgical treatment.Studies have shown that it is related to the history of febrile convulsions,however,the further research is needed.Therefore,it is particularly important to accurately identify hippocampal sclerosis and guide clinical treatment.In this paper,the classification of hippocampal sclerosis was summarized,and the possible mechanism of hippocampal sclerosis was explored in terms of cationic-chloride co-transporters,glutamate and its receptors,and changes in expression of mRNA.The characteristics of magnetic resonance,magnetic resonance spectroscopy and PET of hippocampal sclerosis were listed to provide evidence for early recognition of hippocampal sclerosis.In theory,it provides ideas for further prevention of hippocampal sclerosis and improvement of quality of life in patients with medial temporal lobe epilepsy and hippocampal sclerosis.