Cleveland Clinic Epilepsy Center, Cleveland, Ohio, USA.
Pediatr Neurol. 2011 Jan;44(1):52-6. doi: 10.1016/j.pediatrneurol.2010.07.003.
Epilepsy surgery may successfully treat refractory symptomatic focal epilepsy in patients with coexisting benign focal epileptiform discharges. Reported here is the outcome after resective epilepsy surgery in three children with pharmacoresistant lesional focal epilepsy in whom seizures of benign focal epilepsy of childhood had been recorded. Two patients had left temporal epilepsy due to a malformation of cortical development; one of these had dual pathology, with additional ipsilateral hippocampal sclerosis. One child had catastrophic left hemispheric epilepsy due to left hemimegalencephaly. Frequent, habitual seizures of symptomatic epilepsy resolved after surgery (follow-up duration, 32-55 months); however, rare benign focal seizures of childhood have continued. These cases demonstrate that lesional pharmacoresistant focal epilepsy can be successfully treated with resective epilepsy surgery even when coexisting with benign focal epilepsy of childhood. During postoperative follow-up, careful documentation of breakthrough seizures due to benign focal epilepsy of childhood is important, so that these patients are not labeled as surgical failures.
癫痫手术可能成功治疗共存良性局灶性癫痫样放电的耐药症状性局灶性癫痫。本文报道了 3 例药物难治性局灶性癫痫患儿的手术治疗结果，这些患儿均记录到儿童良性局灶性癫痫发作。2 例患者因皮质发育不良导致左颞叶癫痫，其中 1 例存在同侧海马硬化的双重病变。1 例患儿因左大脑半球巨脑畸形导致灾难性左半球癫痫。手术后频繁、习惯性的症状性癫痫发作得到缓解（随访时间 32-55 个月）；然而，罕见的儿童良性局灶性癫痫仍在继续。这些病例表明，即使共存儿童良性局灶性癫痫，局灶性耐药性癫痫也可以通过癫痫手术成功治疗。术后随访时，重要的是要仔细记录因儿童良性局灶性癫痫而导致的发作突破，以免这些患者被贴上手术失败的标签。
