Alfonso Israel, Vasconcellos Elza, Shuhaiber Hans H, Yaylali Ilker, Papazian Oscar
Department of Neurology, Miami Children's Hospital, Florida, USA.
J Child Neurol. 2004 May;19(5):394-6. doi: 10.1177/088307380401900516.
Early surgical removal of a dysplastic hemisphere appears to be beneficial for neonates with hemimegalencephaly and medically resistant seizures. We analyzed the changes in the cerebral regional oxygen saturation index in a neonate with tuberous sclerosis and right hemimegalencephaly (1) during seven episodes of right hemisphere electroencephalographic status epilepticus with and without clinical manifestations and (2) after right hemispherectomy. The cerebral regional oxygen saturation index demonstrated marked fluctuations and progressive decline in both hemispheres during the episodes and normal values in the remaining hemisphere after surgery. We speculate that decreased oxygenation of the nonepileptic cerebral hemisphere in patients with hemimegalencephaly and medically resistant seizures can contribute to the production of global neurologic impairments in these patients and that the benefits of early hemispherectomy are due to the improved oxygenation of the nondysplastic hemisphere following surgery.
早期手术切除发育异常的半球似乎对患有半侧巨脑症和药物难治性癫痫的新生儿有益。我们分析了一名患有结节性硬化症和右侧半侧巨脑症的新生儿的脑局部氧饱和度指数变化：（1）在七次伴有或不伴有临床表现的右侧半球脑电图癫痫持续状态发作期间；（2）在右侧大脑半球切除术后。脑局部氧饱和度指数在发作期间双侧半球均显示出明显波动和进行性下降，而术后剩余半球的该指数值恢复正常。我们推测，患有半侧巨脑症和药物难治性癫痫的患者中，非癫痫性脑半球的氧合降低可能导致这些患者出现整体神经功能障碍，而早期大脑半球切除术的益处在于术后未发育异常的半球氧合得到改善。
