Samargia Sharyl A, Kimberley Teresa Jacobson
Department of Communicative Disorders, University of Wisconsin, River Falls, WI 54022, USA.
Pediatr Phys Ther. 2009 Winter;21(4):356-61. doi: 10.1097/PEP.0b013e3181bf710d.
Medically intractable epilepsy is a chronic recurrence of seizures that often requires surgery to reduce or eliminate them. Although a reduction of seizures is the primary goal of hemispherectomy, the effect of surgery on motor and cognitive skills is also of importance. This review will provide a discussion of (1) evidence regarding motor and cognitive outcomes, (2) predictors of these outcomes, and (3) neural mechanisms responsible for preservation of function after hemispherectomy.
Motor and cognitive outcomes after hemispherectomy are variable and depend on many predictors including etiology and duration of seizure disorder, age at the time of surgery, premorbid status, and postsurgical seizure control. A refined ipsilateral pathway may explain the preservation of motor function in some children.
A clear understanding of outcome predictors is important for planning effective rehabilitative programs after surgery.
药物难治性癫痫是一种癫痫发作的慢性复发现象，通常需要通过手术来减少或消除发作。虽然减少癫痫发作是大脑半球切除术的主要目标，但手术对运动和认知技能的影响也很重要。本综述将讨论：（1）关于运动和认知结果的证据；（2）这些结果的预测因素；（3）大脑半球切除术后功能保留的神经机制。
大脑半球切除术后的运动和认知结果存在差异，取决于许多预测因素，包括癫痫病因、发作持续时间、手术时年龄、病前状态和术后癫痫控制情况。一条精细的同侧通路可能解释了一些儿童运动功能得以保留的原因。
清楚了解结果预测因素对于规划术后有效的康复方案很重要。
