目的 研究颞叶外节细胞胶质瘤(GG)继发癫痫的临床特点和手术治疗方式及疗效.方法 回顾性分析手术治疗并经病理证实的20例颞叶外节细胞胶质瘤继发癫痫患者的临床资料.术后癫痫控制效果按改良Engel分级标准评定;分析患者的发作表现、病变部位、影像学特点、病理改变、手术方式及病变切除程度与癫痫控制的关系.结果 节细胞胶质瘤位于额叶者2例、顶叶7例、枕叶5例、颞枕交界处6例.MRI检查显示肿瘤为囊性者5例、囊实性6例、实性9例;增强扫描病变有强化12例,病变周围水肿5例.CT检查示病变有钙化4例.癫痫发作表现为简单部分性发作(伴意识保留的局灶性发作)者4例,复杂部分性发作(伴意识障碍的局灶性发作)5例,继发性全面性强直阵挛(局灶进展到双侧的强直阵挛发作)11例.肿瘤次全切除者2例,全切除15例,扩大切除3例.术后病理检查示合并脑皮质发育不良者2例.术后随访1～3年,癫痫控制效果为Engel Ⅰ级17例(85.0％),Ⅱ级2例(10.0％),Ⅲ级1例(5.0％).预后相关临床因素分析显示,肿瘤切除的方式和程度与预后有关.结论 颞叶外节细胞胶质瘤继发癫痫多为药物难治性,手术切除可取得良好效果.术前须综合评估病变部位和临床、影像学特点等资料制定手术策略,术中尽可能行肿瘤加致痫皮层全切除,以提高疗效.必要时可考虑先行SEEG电极植入后,再行致痫灶精准切除术.

目的 探讨胚胎发育不良性神经上皮肿瘤(DNT)继发癫痫的临床特点和手术疗效.方法 回顾性分析2014年12月至2019年1月手术治疗并经病理证实的53例DNT合并癫痫的临床资料.结果 肿瘤次全切除9例,全切除23例,扩大切除21例.术后病理检查结果均为DNT,其中合并局灶性脑皮质发育不良20例、海马硬化4例、神经节细胞胶质瘤4例.术后随访1～3年,Engel分级Ⅰ级43例(81.1％;其中MRI分型Ⅰ型29例,Ⅱ型11例,Ⅲ型3例),Ⅱ级4例(7.5％),Ⅲ级4例(7.5％),Ⅳ级2例(3.8％);术后复查MRI未见肿瘤复发或进展.结论 DNT继发癫痫多为药物难治性癫痫,手术切除可取得良好效果.术前需综合评估病变部位和影像学特点等制定相应的手术方案,术中尽可能全切肿瘤,有助于提高手术疗效.

目的 研究额眶回癫疒间的电临床症状学特点和手术疗效.方法 回顾性分析10例经立体定向脑电图(stereotactic electroencephalogram,SEEG)确诊为额眶回癫疒间的病例资料,总结头皮脑电图、发作症状学、影像学特点及SEEG监测结果的特点.所有病人行致疒间区切除,采用改良Engel分级评估病人术后癫疒间控制情况.结果 术前头皮脑电图显示:10例间期放电均位于一侧额颞区.SEEG监测提示:发作起始区均位于额眶区,其中7例早期扩散至前扣带回或岛叶而表现为过度运动性发作,2例扩散至颞岛叶而表现为自动运动性发作,1例扩散至额叶而表现为简单运动性发作.行额眶回致疒间灶切除8例,扩大切除2例.术后随访2～5年,癫疒间控制达EngelⅠ级8例,Ⅱ级1例,Ⅲ级1例.致疒间灶病理为结节性硬化1例,脑软化2例,FCDⅡa 2例,FCDⅡb 2例,FCDⅠb 3例.术后均未遗留明显功能障碍.结论 额眶回癫疒间间期放电常位于一侧额颞区,以复杂运动性发作为主,因早期扩散区不同导致不同的症状学表现.手术切除致疒间灶时,需警惕额眶回癫疒间附加症的可能.

目的 总结SEEG引导下射频热凝毁损术治疗药物难治性癫痫的手术疗效及治疗体会.方法 对我科2016年12月至2018年5月进行SEEG引导下射频热凝毁损术治疗的13例药物难治性癫痫患者的临床资料进行回顾性分析,并复习相关文献.结果 本组纳入病种包括下丘脑错构瘤,侧脑室壁灰质异位结节及其他皮质发育异常.行SEEG引导下射频热凝毁损术后有7例出现短期并发症:3例偏瘫,2例发热、1例中枢性面瘫,1例视物模糊,出院时均完全恢复.术后常规服用抗痫药物,经过3个月至21个月的随访,10例患者Engle工级,2例EngleⅡ级,1例EngleⅣ级.发作未完全控制患者均再次行开颅手术切除致痫灶,病理分别为FCDⅡa型、MCD(大脑发育畸形)、灰质异位,疗效进一步随访中.结论 SEEG引导下射频热凝毁损术是癫痫外科治疗方案中的一项有力补充,选择合适的病例进行射频热凝毁损术安全有效,甚至可以达到无发作.

目的 研究神经内镜下大脑半球离断术的有效性和安全性.方法 回顾性分析1例药物难治性癫疒间病人的临床资料,采用神经内镜下大脑半球离断术,分析其术后疗效和并发症.结果 术后MRI提示左侧基底核区与周围脑叶完全离断,DTI提示各脑叶与基底核区无纤维传导束联系.术后2周内有发热,予腰大池置管引流后控制;无其他并发症.随访6个月,无癫疒间发作,达EngelⅠ级;神经认知功能较术前改善.结论 对药物难治性癫疒间行神经内镜下大脑半球离断术安全、微创、有效.

OBJECTIVE:To explore the strategy of surgical treatment of low-grade brain tumors associated with epilepsy.METHODS:Clinical data of 158 patients with low-grade brain tumors were collected from January 2011 to December 2017 in Guangdong Sanjiu brain hospital. All patients received Preoperative evaluation. Lesion site: 18 cases were located in multiple cerebral lobes, 10 cases were in the functional zones, 130 cases were in the non-functional zones (including 74 cases were in the medial of temporal lobe). The surgical strategy included subtotal resection, gross-total resection and enlarged resection. Postoperative effects were evaluated by Engel classification.RESULTS:A total of 158 patients underwent surgical treatment, among these patients, only 1 patient underwent intracranial electrode implantation. Surgical methods: 34 cases of subtotal resection, 3 cases of gross-total resection, 119 cases of enlarged resection (including Anterior temporal lobectomy in 74 cases) and 2 case of Selective hippocampal amygdalectomy. The final pathology suggested that there are 74 cases of ganglionglioma, 25 cases of dysembryoplastic neuroepithelial tumors, 9 cases of pilocytic astrocytoma, 16 cases of oligodendroglioma, 10 cases of pleomorphic xanthoastrocytoma, 4 case of diffuse astrocytoma, 9 cases of unclassified astrocytoma, 11 case of oligoastrocytoma. The follow-up time was between 1 and 7 years, with an average of 3.44±1.77 years. Postoperative recovery: 147 patients had an Engel Class I outcome, 10 patients were in Engel Class II, 1 patient was in Class IV.CONCLUSION:The strategy of surgical treatment of low-grade brain tumors associated with epilepsy should pay more attention to the preoperative assessment of the epileptogenic zone. The tumor is not exactly the same as the epileptogenic zone, and the strategy of surgical treatment depends on the tumor feature as well as whether it was located in temporal lobe or involved in functional areas.

目的 研究胼胝体全段切开术治疗药物难治性癫(癇)的安全性和有效性,并探讨其在二期切除性手术的作用.方法 回顾性分析40例药物难治性癫(癇)病例资料,发作类型:强直发作31例,跌倒发作14例,痉挛发作5例,强直-阵挛发作3例和肌阵挛发作3例.经术前评估后行胼胝体全段切开术,术后定期随访癫(癇)控制情况,癫(癇)控制疗效不佳者再行二期手术评估.结果 术后随访1～3年,癫(癇)控制达到EngelⅠ级10例,Ⅱ级11例,Ⅲ级12例,Ⅳ级7例,手术总有效率达82.5％;结果显示:跌倒发作和强直发作减少明显.术后并发症:急性失连接综合征4例,硬膜下积液3例,硬膜下积血1例,经相应处理后恢复正常.术后韦氏智力与记忆力较术前改善(均P<0.05).术后间歇期脑电图(electroencephalogram,EEG)转化为一侧癫(癇)样放电为主29例(72.5％),癫(癇)发作能定侧13例(32.5％).6例病人经再次评估后行二期致(癇)灶切除术,二期手术后癫(癇)无发作.结论 胼胝体全段切开术是一种治疗药物难治性癫(癇)安全有效的方法,同时还可改善病人神经认知功能,且有助于二期致(癇)灶切除术的术前评估定位,但需要严格把握适应证.

Objective To explore the surgical strategies for low-grade glioma and mixed neuron glioma-related epilepsy.Methods The clinical data of 171 patients with low-grade glioma and mixed neuronal glioma-related epilepsy who underwent surgery from 2011 to 2017 in Department of Epilepsy Surgery , Guangdong Sanjiu Brain Hospital were analyzed retrospectively.And the related literatures were reviewed.Results 169 patients underwent non-invasive stage I assessment and obtained resections under the intraoperative cortical electrode monitoring.2 patients underwent SEEG monitoring to determine the extent of epileptogenic zone and then received craniotomy. Patients with neoplastic lesions involving the functional area underwent surgery with intraoperative awakening.32 cases were lesion subtotal resection , and only 6 were lesion total resection.The remaining patients had a larger resection range than the tumor lesions.All patients had no surgical complications such as neurological dysfunction , intracranial infection, and hematoma.Every patient took anti-epileptic drugs after surgery.After 1 to 7 years of follow-up, 149 patients obtained EngleⅠlevel, 19 obtained Engle Ⅱ level, 1 obtained Engle Ⅲ level, 2 obtained Engle Ⅳ level. Conclusions Surgical treatment of low-grade glioma and neuronal mixed glioma-related epilepsy is an important part of epilepsy surgery.It should be evaluated reasonably according to the preoperative evaluation procedure of epilepsy surgery , and individualized surgical strategy can improve the patients’prognosis and quality of life according to the specific situation.

To summarize the diagnosis of tuberous sclerosis and the surgical treatment of its related drug-refractory epilepsy.Methods The clinical data of 10 patients of tuberous sclerosis complicated with drug-refractory epilepsy underwent surgical treatment from April 2015 to July 2018 in Guangdong Sanjiu Brain Hospital were analyzed retrospectively and related literatures were reviewed.In this group of patients, two strategies were proposed for the treatment of epileptogenic foci: direct epithelial cortical electrode monitoring and SEEG monitoring. Results The lesions in patients with tuberous sclerosis involved multiple systems and could cause complex clinical manifestations.The involvement of the nervous system was mainly characterized by drug-refractory epilepsy and cognitive impairment.The types of seizures could be diverse.The EEG showd focal or multifocal spike-slow waves in one hemisphere , or multifocal spike-slow waves in multiple hemisphere or even comprehensive spike-slow waves.MRI showed multiple abnormal signals in the cortex, subcortex and subependymal membrane.Subependymal giant cell astrocytoma could be seen occasionally , while CT examination showed calcification.After 3 months to 3 years and a half of follow-up, all patients were all Engle I grade , except one patient Engle III grade.Conclusions It is not difficult to diagnosis with tuberous sclerosis , according to the clinical manifestations of patients and combining with genetic and imaging examinations.Choosing the right case for active surgical treatment can achieve good results for the tuberous sclerosis patients with drug -refractory epilepsy.

目的 研究迷走神经刺激术(VNS)对药物难治性癫(癇)的有效性和安全性.方法 回顾性分析30例药物难治性癫(癇)病人的临床资料,给予术前评估后实施VNS,通过收集术后定期程控和随访结果,分析术后疗效和并发症.结果 VNS术后随访5～48个月,癫(癇)发作频率减少＞50％ 15例,无发作3例;其中术后发作频率达McHughⅠ A级6例,ⅠB级1例,ⅡA级4例,ⅡB级4例,ⅢA级2例,ⅢB级7例,Ⅳ级2例,V级4例.术后病人的韦氏智力商数均较术前提高(P＜0.05).术后出现声音嘶哑3例,2～3周后自然恢复;皮肤破溃感染1例,取出刺激器.结论 VNS是一种安全、有效的辅助治疗药物难治性癫(癇)的方法,并能一定程度上改善病人神经认知功能和生活质量,但与术后程控密切相关.

目的 总结下丘脑错构瘤的临床特点和手术治疗体会.方法 对我科2013年7月至2018年1月收治的9例诊断为下丘脑错构瘤病例的临床资料进行回顾性分析,并复习相关文献.结果下丘脑错构瘤可引起与病程相关的进展性癫痫性脑病,临床表现为中枢性性早熟、多种癫痫发作及认知和精神方面损害,最具特征性表现为发(痴)笑发作或哭泣样发作但并不是必须存在.脑电图无特异性,详细的核磁共振检查是确诊和分型的重要依据.随着病程的延长,可以在下丘脑错构瘤以外形成新的致痫灶,有时需要电极植入甄别.本组手术病例根据需要采取了不同策略:直接切除下丘脑错构瘤、下丘脑错构瘤加皮层切除、SEEG监测技术下的射频热凝毁损术.经过2个月至4年半的随访,发作均得到较好控制,神经功能损害较术前有不同程度恢复.结论 根据典型临床表现,结合详细的影像学检查,诊断不难.根据下丘脑错构瘤的分型结合病史、发作表现采取不同的治疗策略能获得很好的疗效.

目的:探讨创伤性癫痫(postcrauimdc epilepsy,PTE)的流行病学特征、手术策略及效果分析.方法:回顾性分析71例PT E患者的临床资料,术前行详细术前评估,对未能精准定位致痫灶患者行立体定向脑电图(stereoelectroencephalography,SEEG)电极植入,对全面性癫痫无法行致痫灶定位者,先行胼胝体切开术,如术后转为局灶性发作则再次行术前评估切除致痫灶,而对于双侧致痫灶患者行迷走神经电刺激(vagus nerve stimulation,VNS)治疗.结果:一次性行致痫灶切除者36例,SEEG电极植入后行癫痫灶切除30例(其中2例为胼胝体切开术后患者),单纯胼胝体切开1例,VNS治疗4例.术后随访70例(1例失访),以14岁为年龄界限,分为儿童(≤14岁)和成人(>14岁).分为A组:儿童时期受伤,儿童时期手术25例,EngelⅠ级22例(88％);B组:儿童时期受伤,成人时期手术37例,EngelⅠ级20例(54％);C组:成人时期受伤,成人时期手术8例,EngelⅠ级7例(88％).A组和B组行Fisher检验,P<0.05,A组和C组、B组和C组Fisher检验,P>0.05,综合显示儿童受伤后儿童时期手术预后较成人时期手术好,而受伤年龄和癫痫手术预后无相关性.结论:外科手术是治疗PTE重要且有效的方法.术前详细评估,对于疑难患者行SEEG精准定位致痫灶,术后多数可得到满意的疗效.胼胝体切开、VNS也是PTE的重要辅助治疗方式.术后随访发现儿童患者儿童时期手术预后较成人时期好,所以对于药物难治性PTE儿童患者,建议尽早手术,以期尽早控制癫痫发作,避免患者神经功能受到二次损害,使其神经功能得到良好发育.

Objective To explore the clinical features and surgical treatment strategy of occipital lobe epilepsy .Methods The clinical data of 14 patients with occipital lobe epilepsy who were confirmed by noninvasive preoperative evaluation or invasive stereotactic electroencephalography ( SEEG ) technique from June 2014 to June 2017 in our department were analyzed retrospectively and relevant literatures were reviewed .Results Four patients with low-grade developmental tumors underwent direct craniotomy which included the lesion and the epileptiform discharge area .In one case , only the lesion was excised because no epileptiform discharge was detected in surgery .10 patients underwent SEEG technique to determine the epileptogenic zone before surgery .2 underwent SEEG-guided radiofrequency thermocoagulation and the others underwent craniotomy .The main complication after the operation was visual field defect or original visual field defect worse .After the operation , anti-epileptic drugs were routinely taken .The follow-up from 6 months to 3 years showed there were 12 cases of Engle classⅠ,1 Engle classⅢand 1 Engle class Ⅳ.Conclusions Although the clinical manifestation of occipital lobe epilepsy is complex ,scalp electroencephalography has limited significance in locating the side , it still can be accurately diagnosed through detailed normative preoperative evaluation , especially the evolution of symptoms and stereoscopic EEG monitoring techniques .Furthermore , it can obtain good result by taking individualized surgical treatment strategies .

目的 探讨Rasmussen脑炎的诊断和手术治疗.方法 回顾性分析广东三九脑科医院2014年4月至2017年6月,经手术治疗及病理检查证实的5例Rasmussen脑炎患者的临床资料;并复习相关文献.结果 本组患者的临床表现为单侧大脑半球皮层炎症、药物难治性癫痫及进展性神经功能和认知功能损害.最具特征性的表现为进展性局部脑皮层萎缩和部分性癫痫发作持续状态(EPC).癫痫发作的类型多样,但EPC发作一般不继发全面性强直阵挛发作.脑电图表现无特异性,为患侧广泛性慢波、棘-慢波,甚至波及对侧.MRI典型表现为T2FLAIR局灶性皮层及皮层下、尾状核头部高信号,并且病灶可以随着病程延长不同程度的扩大.PET检查表现为较局灶性病灶明显扩大的低代谢范围.本组患者均经侧裂入路行解剖式大脑半球切除术,包括岛叶皮层切除.术后随访8个月至3年,患者的癫痫发作均得到完全控制,神经功能损害均较术前有不同程度恢复.结论 根据好发年龄及典型临床表现,结合影像学检查,Rasmussen脑炎的诊断不难.积极采取合理的治疗方法,特别是外科大脑半球切除术,患者能获得良好的疗效.

目的 总结脑裂头蚴病的诊断和手术治疗体会.方法 对2014~2016年手术治疗的22例脑裂头蚴病的临床资料进行回顾性分析,并复习相关文献.结果 脑裂头蚴病的临床表现以癫痫、轻瘫、偏身感觉障碍常见,也可仅有头痛症状;病灶常单发,以额、顶叶中央区常见;MRI表现为T1WI低信号、T2WI高信号的不规则片状异常信号灶,增强后为环形、串珠样或条索样局部强化,可见"隧道征";CT为低密度灶,可见强化或钙化;病灶有迁徙性.本文病例成功抓到活虫,术后均未出现明显功能障碍或原有功能障碍加重.术后常规服用抗癫痫药物控制癫痫,未常规给予吡喹酮治疗.随访3个月至2年,癫痫及头痛症状均消失;MRI复查强化病灶均消失.结论 对于脑裂头蚴病,根据好发年龄及生活史,结合典型影像学、血清免疫学检查,诊断不难.详细的病史询问及阅片后在导航、术中唤醒技术辅助下手术能成功清除活虫,预后良好.

目的 探讨多形性黄色星形细胞瘤的临床及影像学特征.方法 对2012年1月至2016年6月在广东三九脑科医院癫痫外科,接受手术治疗的10例多形性黄色星形细胞瘤患者的临床及影像学资料进行回顾性分析.结果 MRI检查示,10例患者均为囊实性改变,其中3例患者为大结节小囊、7例患者为小结节大囊;病变位于左颞叶7例、左颞枕交界区1例、右颞叶1例及左侧额中央区1例;增强扫描示,7例患者的肿瘤实性部分和壁结节明显强化,1例患者软脑膜强化,2例患者无强化.8例患者行肿瘤全切术,2例患者行部分切除术.10例患者的临床疗效均满意,术后9例癫痫患者均无发作,1例患者的头痛缓解.随访时间为1～5年不等,术后复查均无复发征像.结论 多形黄色星形细胞瘤临床表现多以癫痫发作起病;影像学检查常见囊结节改变,病变多位于幕上,占位及水肿效应轻.最终诊断需依赖病理学检查.

Apoptosis after traumatic brain injury has been shown to be a major factor influencing prognosis and outcome. Endoplasmic reticulum stress may be involved in mitochondrial mediated neuronal apoptosis. Therefore, endoplasmic reticulum stress has become an important mechanism of secondary injury after traumatic brain injury. In this study, a rat model of traumatic brain injury was established by lateral fluid percussion injury. Fluorescence assays were used to measure reactive oxygen species content in the cerebral cortex. Western blot assays were used to determine expression of endoplasmic reticulum stress-related proteins. Hematoxylin-eosin staining was used to detect pathological changes in the cerebral cortex. Transmission electron microscopy was used to measure ultrastructural changes in the endoplasmic reticulum and mitochondria. Our results showed activation of the endoplasmic reticulum stress-related unfolded protein response. Meanwhile, both the endoplasmic reticulum stress response and mitochondrial apoptotic pathway were activated at different stages post-traumatic brain injury. Furthermore, pretreatment with the endoplasmic reticulum stress inhibitor, salubrinal(1 mg/kg), by intraperitoneal injection 30 minutes before injury significantly inhibited the endoplasmic reticulum stress response and reduced apoptosis. Moreover, salubrinal promoted recovery of mitochondrial function and inhibited activation of the mitochondrial apoptotic pathway post-traumatic brain injury. These results suggest that endoplasmic reticulum stress might be a key factor for secondary brain injury post-traumatic brain injury.

Objective To explore the safety of intracranial electrode implantation under help of Robotized stereotactic assistant (ROSA)-guided stereoelectroencephalography (SEEG) and its value to surgery for intractable epilepsy in children. Methods Nineteen children under 14 years of age with intractable epilepsy were preoperatively assessed by MRI, video-EEG, PET-CT and so on and then the implantation of intracranial electrode, by which the long-term intracranial EEG was recorded, was performed under the help of ROSA-guided SEEG in order to locate the epileptogenic zone. The surgery was performed after the location of the epileptogenic zone in all the patients. Results A total of 222 intracranial electrodes were successfully implanted in all the children. The electrodes were implanted in the left cerebral hemisphere in 11 children, in the right ones in 7 and in bilateral ones in 1. There were no complications such as bleeding, cerebrospinal fluid leakage, electrode fracture and infection in all the children after the implantation. The epileptogenic zones were exactly located and successfully resected by surgery in all the children. Two patients had transient hemiparesis after the surgery. The following up from 12 to 24 months showed that the epileptic control effect was Engel gradeⅠin 15 children, gradeⅡin 1, gradeⅢin 1 and gradeⅣin 2. Conclusions The intracranial electrode implantation under the help of ROSA-guided SEEG is safe and may decrease in the postoperative complications and improvement of prognosis in the children with intractable epilepsy.

目的 探讨起源于额叶背外侧癫痫发作的运动症状对应亚区分布特点.方法 回顾性分析19例经立体脑电图(SEEG)证实发作起源于额叶背外侧并经外科切除治疗的局灶性癫痫患者临床资料.将患者发作症状中的运动成分分为基本运动(Elementary motor,EM,包括强直、偏转、阵挛、肌阵挛等)与复杂运动(Complex motor,CM,包括自动运动、过度运动等)两大类.在磁共振成像大脑矢状位图像序列上建立Talairach坐标系,自VAC线与外侧裂交点起始斜向前上方建立一条与AC-PC线呈60°角的射线,把额叶分为前部和后部.然后将SEEG证实为致痫区(发作起始或早期扩散)的电极触点进行定位并分为三类:额前部、额后部和额中间型(跨界分布)致痫区.分析发作中的运动成分与发作起源前后分布位置的相关性.结果 19例患者中致痫区定位额前部癫痫5例(26.3％),其中2例EM,1例CM,2例EM+ CM;额中间型癫痫7例(36.8％),其中1例EM,无CM,6例EM+ CM;额后部癫痫7例(36.8％),其中6例EM,无CM,l例EM+ CM.相较于致痫区累及额前部者,额后部癫痫更多表现为单纯的基本运动(85.7％)而甚少出现复杂运动成分(P＜0.05);相较于额前部和额后部癫痫,额中间型癫痫更多表现为EM+ CM(85.7％) (P ＜0.05).结论 额叶背外侧癫痫发作的运动症状与致痫区定位有明显关联,额后部致痫区发作运动症状以基本运动成分为主,一旦致痫区向前累及,则症状往往会出现复杂运动成分;前后跨界分布的致痫区更易出现“组合运动症状”.在AC-PC坐标系建立“60.线”对额叶症状学定位可能有辅助价值.

Objective To analysis the clinical characters of temporal lobe epilepsy ( TLE ) associated with low-grade tumor and explore a suitable surgical stratagy .Methods The clinical data of 27 patients with TLE associated with low-grade tumor treated from January 2013 to January 2014 were analyzed retrospectively .The clinical characteristics ,surgical removal strategy and postoperative efficacy were analyzed.Results The lesions were located in lateral, mesial, basal, and posterior temporal lobe , respectively , and a few were extended to extemporal lobe .The earliest seizure semiology included psychiatric aura , autonomic aura, visual hallucination , dialeptic, aphasia, automotor, complex motor, and even generalized tonic-clonic seizure.Of 27 patients, 5 received total lesion resection , 20 underwent extensive resection , while 2 gained subtotal resection .No severe neural functional deficit was observed .After at least one year ’ s follow-up, except only one patient whose tumor wasn ’ t removed completely gained Engel Class Ⅱ, all 26 patients ( 96 .3%) gained Engel Class Ⅰ.Conclusions TLE associated with low-grade tumor could show various seizure semiology as tumors locate in various part of temporal lobe and involve different epileptic network.Strict presurgical evaluation is needed to indentify relationship of tumor and epileptogenic zone ,and to design suitable plan for thoroughresection of them in safety .When necessary ,techniques such as neuronavigation , awake surgery ,and intracranial electrodes implantation should be applied . Excellent seizure control can be achieved after surgery .