Department of Neurosurgery, Beijing Jishuitan Hospital, Fourth Medical College of Peking University, Beijing 100035, China.
Chin Med J (Engl). 2009 Aug 5;122(15):1769-74.
In the years around 1990, in Beijing Tiantan Hospital Affiliated to Capital Medical University many children with infantile hemiplegia and intractable epilepsy were treated with further modified anatomical hemispherectomy. We report the follow up of the first six cases. To make good use of these precious clinical data and make clear their neuropsychological state, we performed neuropsychological and neurophysiological measurements in these patients, who were at a median of 17.8 years after hemispherectomy.
Oddball task was given to the patients and to a normal control group to collect the peak latency (PL) and peak amplitude (PA) of event-related potentials (ERPs)-P300. The P300 data of the two groups were analyzed and the P300 patterns of the six patients are presented. The baseline characteristics and long-term follow-up of the six hemispherectomized patients, especially the long-term seizure control and cognitive function after surgery, are described.
Five patients had no seizures and one was almost seizure-free during the years after surgery. Clear P300 was obtained from every electrode in the patients. Differences of P300 between patients and normal control group had no statistical significance. And the maximum PA was at the site of electrode Pz or Cz which was consistent with that of the control group and with previous findings.
Further modified anatomical hemispherectomy has preferable long-term antiepileptic effects. The P300 results of the patients mean that the basic cognitive function of the patients has no difference from the control group. This reflects the plasticity of the hemisphere to some extent and increases the affirmation of the long-term curative effects of further modified anatomical hemispherectomy from both neuropsychological and neurophysiological aspects.
在 1990 年前后，首都医科大学附属北京天坛医院对多名患有婴儿偏瘫和难治性癫痫的儿童进行了进一步改良的解剖性大脑半球切除术。我们报告了前六例患者的随访结果。为了充分利用这些宝贵的临床数据并明确他们的神经心理状态，我们对这些患者进行了神经心理学和神经生理学测量，他们在大脑半球切除术后的中位数时间为 17.8 年。
对患者和正常对照组进行了Oddball 任务，以收集事件相关电位（ERP）-P300 的峰潜伏期（PL）和峰幅度（PA）。分析了两组的 P300 数据，并呈现了六名患者的 P300 模式。描述了六名大脑半球切除术患者的基线特征和长期随访结果，特别是手术后脑功能长期控制和认知功能。
五名患者术后多年无发作，一名患者几乎无发作。每位患者的每个电极都获得了清晰的 P300。患者与正常对照组之间的 P300 差异无统计学意义。最大 PA 位于电极 Pz 或 Cz 处，与对照组和先前的研究结果一致。
进一步改良的解剖性大脑半球切除术具有较好的长期抗癫痫效果。患者的 P300 结果表明患者的基本认知功能与对照组无差异。这在一定程度上反映了大脑半球的可塑性，从神经心理学和神经生理学两个方面增加了对进一步改良的解剖性大脑半球切除术长期疗效的肯定。
