Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Pediatr Neurol. 2010 Jan;42(1):12-20. doi: 10.1016/j.pediatrneurol.2009.07.018.
A consecutive, retrospective analysis of seizure control and quality of life was performed among 83 pediatric patients undergoing epilepsy surgery at Children's Hospital of Wisconsin. Seizure outcomes were generally favorable, with 68.7% class I outcomes; class II, 12%; and class III, 19.3%. Seizure freedom was highest among temporal lobectomies (84.2%) and hemispherectomies (76.2%). Outcomes among hemispherectomies were substantially superior to those of multilobar resections. Cortical dysplasia was associated with lower seizure freedom, at 57.5%. Among age groups, seizure-free outcomes in infants were lowest, at 50%. The lower infant seizure-free rate was likely attributable to frequency of multilobar resections and type of pathology (cortical dysplasia). Quality-of-life measures generally paralleled seizure outcomes. These results indicate that epilepsy surgery in children with intractable epilepsy can result in significant improvements in seizure control, quality of life, and development. Anticipated type of surgery, presumed location of epileptogenic site, absence of a defined lesion on magnetic resonance imaging scan of the brain, and patient's age should not prevent surgical evaluations of children with intractable epilepsy.
威斯康星州儿童医院对 83 名接受癫痫手术的儿科患者进行了一项连续的回顾性分析，以评估其癫痫控制和生活质量。总体而言，手术效果良好，其中 I 级结果占 68.7%，II 级占 12%，III 级占 19.3%。颞叶切除术（84.2%）和半球切除术（76.2%）的癫痫无发作率最高。半球切除术的结果明显优于多脑叶切除术。皮质发育不良与较低的无癫痫发作率（57.5%）相关。在各年龄段中，婴儿的无癫痫发作率最低，为 50%。婴儿无癫痫发作率较低可能归因于多脑叶切除术的频率和病变类型（皮质发育不良）。生活质量测量结果通常与癫痫发作结果平行。这些结果表明，对于难治性癫痫儿童，癫痫手术可以显著改善癫痫控制、生活质量和发育。预期的手术类型、致痫区的假定位置、脑部磁共振成像扫描无明确病变以及患者年龄不应阻止对难治性癫痫儿童进行手术评估。
