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结节性硬化症的癫痫手术:早期预测因素及结果

Epilepsy surgery in tuberous sclerosis complex: early predictive elements and outcome.

作者信息

Teutonico F, Mai R, Devinsky O, Lo Russo G, Weiner H L, Borrelli P, Balottin U, Veggiotti P

机构信息

Child Neuropsychiatry Unit, Department of Child Neurology and Psychiatry, IRCCS C. Mondino Foundation, University of Pavia, Via Mondino, 2, 27100, Pavia, Italy.

出版信息

Childs Nerv Syst. 2008 Dec;24(12):1437-45. doi: 10.1007/s00381-008-0679-4. Epub 2008 Aug 14.

Abstract

AIM

The aim of the study was to evaluate the surgical treatment of epilepsy and detection of possible early surgery predictive elements in patients with tuberous sclerosis complex (TSC).

MATERIALS AND METHODS

Forty-two TSC patients with epilepsy were selected and divided into two main groups: definite and fruste forms. Definite forms were divided into different groups: patients with pharmacologically controlled epilepsy, patients with pharmacoresistant epilepsy excluded from surgery after an extensive presurgical assessment, and patients with a pharmacoresistant epilepsy who underwent surgery. We compared the definite TSC groups to identify elements that predict surgical candidacy. Second, we compared all operated patients to assess surgical outcome.

CONCLUSION

We found several factors that could predict a surgical intervention even if identification of patients with refractory epilepsy who can benefit from surgery is an evolving process. Also, several positive factors for good surgical outcome were identified. Patients with the fruste form had excellent surgical outcome.

摘要

目的

本研究旨在评估结节性硬化症(TSC)患者的癫痫手术治疗情况,并检测可能的早期手术预测因素。

材料与方法

选取42例患有癫痫的TSC患者,分为两个主要组:典型型和顿挫型。典型型再分为不同组:药物控制癫痫的患者、经过广泛术前评估后被排除手术的药物难治性癫痫患者、以及接受手术的药物难治性癫痫患者。我们比较典型TSC组以确定预测手术候选资格的因素。其次,我们比较所有接受手术的患者以评估手术结果。

结论

我们发现了几个即使在确定哪些难治性癫痫患者可从手术中获益仍处于不断发展过程中时也能预测手术干预的因素。此外,还确定了几个手术结果良好的积极因素。顿挫型患者的手术结果极佳。

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