Ng Yu-Tze, Kerrigan John F, Rekate Harold L
Department of Pediatric Neurology, Barrow Neurological Institute, Phoenix, Arizona 85013, USA.
J Neurosurg. 2006 Nov;105(5 Suppl):378-81. doi: 10.3171/ped.2006.105.5.378.
The purpose of this study was to report the cases of five patients with status epilepticus who were treated successfully with neurosurgery.
Five children presented with refractory status epilepticus, including complex partial status epilepticus, epilepsia partialis continua and "status gelasticus." Multiple medical therapies had failed to control the seizures, and focal resection was performed. Seizures were fully controlled in four patients, and in one patient seizure frequency was reduced by more than 90%.
Refractory status epilepticus is associated with a high mortality rate and by definition does not respond well to medical treatment, even optimal medical treatment. Neurosurgical treatment should be considered as another therapeutic option once medical management has failed, and neurosurgery should not necessarily be a last resort.
本研究旨在报告5例成功接受神经外科手术治疗的癫痫持续状态患者的病例。
5名儿童出现难治性癫痫持续状态，包括复杂部分性癫痫持续状态、持续性部分性癫痫和“笑性癫痫持续状态”。多种药物治疗未能控制癫痫发作，遂进行局灶性切除。4例患者的癫痫发作得到完全控制，1例患者的癫痫发作频率降低了90%以上。
难治性癫痫持续状态死亡率高，根据定义，即使是最佳药物治疗，对其治疗效果也不佳。一旦药物治疗失败，应将神经外科治疗视为另一种治疗选择，神经外科治疗不一定是最后的手段。
