Adelson P D, Peacock W J, Chugani H T, Comair Y G, Vinters H V, Shields W D, Shewmon D A
Division of Neurosurgery, UCLA School of Medicine 90024-6901.
Pediatr Neurosurg. 1992;18(4):169-78. doi: 10.1159/000120659.
In our series of 33 children who underwent temporal and extended temporal lobe resections because of seizures, the average age at surgery was 7 years, 11 months. Sixteen cases (48%) were diagnosed as having tumors: low-grade astrocytoma (6), hamartoma (5), and ganglioglioma/neuroma (5). Other pathologic diagnoses included one or more cytoarchitectural abnormalities and/or reactive changes. Due to a more aggressive and early radiologic and electrophysiologic investigation of children with seizures, a resectable focus, e.g. neoplasm or structural abnormality, was found in a much younger age group of patients than previously reported. In children who had intractable seizures but normal radiologic studies, positron emission tomography was of great value in localizing the seizure focus. In a group of children with infantile spasms, seizures were controlled following the identification and resection of a focal lesion. Prompt detection and precise localization of lesions in the temporal lobe in the pediatric population may lead to surgical management and seizure control.
在我们这组因癫痫接受颞叶及扩大颞叶切除术的33例儿童中，手术时的平均年龄为7岁11个月。16例（48%）被诊断患有肿瘤：低级别星形细胞瘤（6例）、错构瘤（5例）和节细胞胶质瘤/神经瘤（5例）。其他病理诊断包括一种或多种细胞结构异常和/或反应性改变。由于对癫痫儿童进行了更积极、早期的放射学和电生理学检查，与之前报道相比，在年龄小得多的患者群体中发现了可切除病灶，如肿瘤或结构异常。对于患有顽固性癫痫但放射学检查正常的儿童，正电子发射断层扫描在确定癫痫病灶方面具有重要价值。在一组患有婴儿痉挛症的儿童中，在发现并切除局灶性病变后癫痫得到了控制。在儿科人群中及时发现并精确确定颞叶病变可能会带来手术治疗并控制癫痫发作。
