側頭葉性癲癇に対する扁桃核剔除術の効果

Effect of Amygdalectomy on the Temporal Lobe Seizure

緒言

　近年側頭葉性癲癇の焦点として，側頭葉前端部皮質のみでなく側頭葉内側皮質，島囲灰白質，海馬，扁桃核及びその周辺部の重要性も諸家により指摘されて来た^1）−5）。

　又，すでにThompson　＆　Walker （1950）^6），Williams　＆　Freeman （1951）^7）−9）以来，扁桃核と精神運動機構が関連づけられ，この扁桃核の別除が精神錯乱状態を鎮静ならしめ，又前頭葉切截術では除去し難い幻聴を消失させ得るとされ，主に精神病患者に試みられた^10）11）。更に，Williams（1953）の記載によれば，Velasco-Suarez^12）は幻覚を有する精神運動発作癲癇2例に対しても，この扁桃核剔除術を試み良結果を得たという。

Unilateral amygdalectomy was performed on five cases of the temporal lobe seizure ex-cept one which was bilaterally amygdalecto-mized, and its postoperative course and sur-gical effect were observed.

Three cases, in five, had bilateral foci and remaining two cases had unilateral focus. By amygdalectomy, not only the cease of clinical attacks of the temporal lobe seizure but also improvement of abnormal behavior and cha-racter, and placidity and furthermore some improvement of abnormal preoperative EEG findings were obtained.

Tendency of recurrence of the attack in the following few years which is well controlled by anticonvulsant can not be denied, however, this relatively simple surgical procedure, amy-gdalectomy, has no possibility of side-effects which might occur following temporal loboto-my and therefore I believe this is a notewor-thy operation for temporal lobe seizure.