Desai Neely, Pressler Ronit M, Jolleff Nicola, Clark Maria, Neville Brian, Eltze Christin, Harkness William, Cross J Helen
Great Ormond Street Hospital for Children NHS Trust & UCL-Institute of Child Health, London, England.
Epileptic Disord. 2008 Dec;10(4):356-61. doi: 10.1684/epd.2008.0214.
We report the case of a six-year-old boy who presented in infancy with infantile spasms and left focal seizures. An MR scan at two months was suggestive of a right parietal cortical dysplasia, although this was less apparent on repeat scan at 11 months. The initial response to anti-epileptic medications was good; surgery was therefore deferred at that time. Subsequently, seizure control fluctuated and developmental progress was, on the whole, good. However, ultimately seizures increased despite changing the AED, and he began showing developmental problems. Surgery was reconsidered. Again, a repeat MR scan did not define the lesion well. Following full further evaluation, including functional imaging that still implicated the right parietal cortex, subdural grid and depth electrode monitoring were undertaken at 6.5 years, which located the ictal onset zone deep within the lesion. This enabled a right inferior parietal lobe resection to be performed. Four years post-surgery he remains seizure-free and has shown progress in development.
我们报告了一名6岁男孩的病例，该男孩在婴儿期出现婴儿痉挛和左侧局灶性癫痫发作。两个月时的磁共振成像扫描提示右侧顶叶皮质发育异常，不过在11个月时的复查扫描中这种异常不太明显。最初对抗癫痫药物的反应良好；因此当时推迟了手术。随后，癫痫控制情况波动，总体发育进展良好。然而，尽管更换了抗癫痫药物，癫痫发作最终还是增加了，并且他开始出现发育问题。于是重新考虑手术。再次进行的磁共振成像扫描仍未很好地明确病变。经过全面的进一步评估，包括功能成像仍提示右侧顶叶皮质有问题，在6.5岁时进行了硬膜下格栅电极和深部电极监测，确定发作起始区位于病变深处。这使得能够进行右侧顶叶下叶切除术。术后四年，他一直无癫痫发作，并且在发育方面取得了进步。
